Provider Demographics
NPI:1871721126
Name:MENDES, HANNAH MICHELLE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:MICHELLE
Last Name:MENDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 TOPANGA CANYON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1350
Mailing Address - Country:US
Mailing Address - Phone:818-882-0200
Mailing Address - Fax:
Practice Address - Street 1:10824 TOPANGA CANYON BLVD
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-1350
Practice Address - Country:US
Practice Address - Phone:818-882-0200
Practice Address - Fax:818-882-0206
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1048235Z00000X
CA17569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist