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Tracy Kim Mendoza
Licensed Psychiatric Technician in Los Angeles, California
NPI 1255877437

Tracy Kim Mendoza is a Licensed Psychiatric Technician based in Los Angeles, CA. Tracy Kim Mendoza practices in Los Angeles, CA. The NPI Number for Tracy Kim Mendoza is 1255877437 and holds a License No. PT34003 (California).

The current practice location address for Tracy Kim Mendoza is 12021 Wilmington Ave, Los Angeles, CA and can be reached out via phone at 310-221-6336.

Location: 12021 Wilmington Ave, Los Angeles, CA, 90059-3019
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255877437
Provider Name
Tracy Kim Mendoza
Credential
Provider Entity Type
Individual
Gender
Female
Address
12021 Wilmington Ave, Los Angeles, CA, 90059-3019
Phone Number
310-221-6336
Fax Number
Provider Enumeration Date
01/12/2017
Last Update Date
09/14/2024
institution
Provider Business Practice Location Address Details
Address
12021 Wilmington Ave
City
Los Angeles
State
California
Zip
90059-3019
Phone Number
310-221-6336
Fax Number
person
Provider Business Mailing Address Details
Address
12021 Wilmington Ave
City
Los Angeles
State
California
Zip
90059-3019
Phone Number
310-221-6336
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Psychiatric Technician
Speciality
-
Taxonomy
167G00000X
License No.
PT34003 (California)
Definition
An individual licensed by the state board as a Psychiatric Technician based upon completion of a prescribed course of theory and clinical practice, with two thirds of the clinical practice time focused on mental and developmental disorders. The psychiatric technician practices under the direct supervision of a physician, psychologist, registered nurse or other professional to provide care to patients with mental disorders and developmental disabilities.
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