Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alisa Josefina Mendoza, PA

Individual provider Physician Assistant · NPI 1174412910

Alisa Josefina Mendoza, PA is a Physician Assistant in San Bernardino, California. Qualified in 2025, 1 year ago. Practices as a sole proprietor. Licensed in California.

Years since qualifying
1
Licensed in
CA
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2101 N Waterman Ave
San Bernardino, CA 92404-4836
Phone: (909) 883-8711
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA67119 (CA)

Record details

NPI number1174412910
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 28, 2025
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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