Provider Demographics
NPI:1043556178
Name:MATHEW, MERCY HEMA (MS, PPS)
Entity Type:Individual
Prefix:MRS
First Name:MERCY HEMA
Middle Name:
Last Name:MATHEW
Suffix:
Gender:F
Credentials:MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6303 OWENSMOUTH AVE. FI 10
Mailing Address - Street 2:DIRECTED SPECIALIZED SERVICES LLC
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367
Mailing Address - Country:US
Mailing Address - Phone:323-391-1622
Mailing Address - Fax:323-391-1622
Practice Address - Street 1:6303 OWENSMOUTH AVE. FI 10
Practice Address - Street 2:DIRECTED SPECIALIZED SERVICES LLC
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:323-391-1622
Practice Address - Fax:323-391-1622
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool