ROSE MENDIOLA NPI 1417324872

NPI Information

NPI: 1417324872
Provider Name: ROSE MENDIOLA
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Individual
Address:
130 STANFORD DR
VALLEJO, CA
ZIP 94589
Phone: (707) 246-7971
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Rose Mendiola is a substance abuse rehabilitation facility in Vallejo, CA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. Rose Mendiola NPI is 1417324872. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

130 STANFORD DR
VALLEJO, CA
ZIP 94589-746
Phone: (707) 246-7971

The enumeration date for this NPI number is 9/1/2015 and was last updated on 9/1/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		R36801214	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C0600029	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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