Provider Demographics
NPI:1700228780
Name:TAMAYO, MERCEDES (MENTAL HEALTH WORKER)
Entity Type:Individual
Prefix:MS
First Name:MERCEDES
Middle Name:
Last Name:TAMAYO
Suffix:
Gender:F
Credentials:MENTAL HEALTH WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7326
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91409-7326
Mailing Address - Country:US
Mailing Address - Phone:818-749-0059
Mailing Address - Fax:
Practice Address - Street 1:18567 SATICOY ST APT 48
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-7438
Practice Address - Country:US
Practice Address - Phone:818-749-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist