Individual
GINA MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4959 PALO VERDE ST, #206A-4, MONTCLAIR, CA 91763-2331
(909) 582-5021
Mailing address
1617 W BENBOW ST, SAN DIMAS, CA 91773-3414
(909) 582-5021
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN 542569
CA
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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