Individual
GENESIS MARIE MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3433 W SHAW AVE STE 107, FRESNO, CA 93711-3229
(559) 476-2115
Mailing address
3433 W SHAW AVE STE 102, FRESNO, CA 93711-3229
(559) 558-4051
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
MPSS-QBRXMU
CA
Other
Enumeration date
09/06/2019
Last updated
01/09/2024
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