Provider Demographics
NPI:1801319454
Name:MERCADO, ROCIO (MS)
Entity type:Individual
Prefix:MISS
First Name:ROCIO
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 N REEDER AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91724-2126
Mailing Address - Country:US
Mailing Address - Phone:951-332-1377
Mailing Address - Fax:
Practice Address - Street 1:919 N REEDER AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91724-2126
Practice Address - Country:US
Practice Address - Phone:951-332-1377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
CALMFT133859106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist