Provider Demographics
NPI:1932486511
Name:HINESTROZA, MERCEDES CRISTINA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MERCEDES
Middle Name:CRISTINA
Last Name:HINESTROZA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:MERCEDES
Other - Middle Name:CRISTINA
Other - Last Name:HARRISON-HINESTROZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:25925 BARTON RD UNIT 714
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-5633
Mailing Address - Country:US
Mailing Address - Phone:909-344-5460
Mailing Address - Fax:
Practice Address - Street 1:24187 PAULSON DR
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-4873
Practice Address - Country:US
Practice Address - Phone:909-809-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-09
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114159106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist