Provider Demographics
NPI:1831422963
Name:MERCADO, PATRICIA (BA)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MERCADO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 CAMINO DEL RIO S STE 142
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3737
Mailing Address - Country:US
Mailing Address - Phone:877-775-3003
Mailing Address - Fax:
Practice Address - Street 1:2515 CAMINO DEL RIO S STE 142
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3737
Practice Address - Country:US
Practice Address - Phone:877-775-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator