Provider Demographics
NPI:1851729768
Name:UCHENDU, MERCY A (DNP, FNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MERCY
Middle Name:A
Last Name:UCHENDU
Suffix:
Gender:F
Credentials:DNP, FNP, PMHNP-BC
Other - Prefix:
Other - First Name:MERCY
Other - Middle Name:
Other - Last Name:MANEAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:38850 HIGH RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-8070
Mailing Address - Country:US
Mailing Address - Phone:909-991-9495
Mailing Address - Fax:
Practice Address - Street 1:6529 RIVERSIDE AVE STE 133
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3123
Practice Address - Country:US
Practice Address - Phone:951-684-2627
Practice Address - Fax:951-263-7260
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-31
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21619363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty