Provider Demographics
NPI:1235862806
Name:MENDEZ-LOREDO, CYNDI AYANNA
Entity type:Individual
Prefix:
First Name:CYNDI
Middle Name:AYANNA
Last Name:MENDEZ-LOREDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:LOREDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9620 NE TANASBOURNE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7844
Mailing Address - Country:US
Mailing Address - Phone:541-818-0009
Mailing Address - Fax:541-780-6967
Practice Address - Street 1:9620 NE TANASBOURNE DR STE 300
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7844
Practice Address - Country:US
Practice Address - Phone:541-818-0009
Practice Address - Fax:541-780-6967
Is Sole Proprietor?:No
Enumeration Date:2022-07-01
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR999999999999Medicaid