Provider Demographics
NPI:1457033136
Name:MERCADO-FORSECK, ADRIANA MARIA (LCCE, CD(DONA))
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:MARIA
Last Name:MERCADO-FORSECK
Suffix:
Gender:F
Credentials:LCCE, CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 E H ST
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-2011
Mailing Address - Country:US
Mailing Address - Phone:619-616-9456
Mailing Address - Fax:
Practice Address - Street 1:1630 E H ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-2011
Practice Address - Country:US
Practice Address - Phone:619-616-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12140374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula