Basic Information
Provider Information | |||||||||
NPI: | 1821228503 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | MENDOZA | ||||||||
FirstName: | APRIL ARRA | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MISS | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 18860 SEABISCUIT RUN | ||||||||
Address2: |   | ||||||||
City: | YORBA LINDA | ||||||||
State: | CA | ||||||||
PostalCode: | 928862665 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7142641546 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2101 E 1ST ST | ||||||||
Address2: |   | ||||||||
City: | SANTA ANA | ||||||||
State: | CA | ||||||||
PostalCode: | 927054007 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7145423581 | ||||||||
FaxNumber: | 7145422246 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/16/2009 | ||||||||
LastUpdateDate: | 03/23/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: | 08/03/2021 | ||||||||
NPIReactivationDate: | 10/26/2021 | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 03/23/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 242281 | CA | N |   | Nursing Service Providers | Licensed Vocational Nurse |   | 363LF0000X | 95016743 | CA | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.