Individual
ELIZABETH MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 PARK AVE, MODESTO, CA 95354-0556
(209) 558-4595
Mailing address
920 16TH ST STE B, MODESTO, CA 95354-1119
(209) 552-2817
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-FCTQPH
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2023
Last updated
08/28/2025
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