Provider Demographics
NPI:1831563386
Name:MERCADO, DINAH SALUMBIDES (PTA)
Entity type:Individual
Prefix:
First Name:DINAH
Middle Name:SALUMBIDES
Last Name:MERCADO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DINAH
Other - Middle Name:
Other - Last Name:SALUMBIDES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:10716 LA TUNA CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2130
Mailing Address - Country:US
Mailing Address - Phone:818-252-5863
Mailing Address - Fax:818-252-6450
Practice Address - Street 1:10716 LA TUNA CANYON RD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2130
Practice Address - Country:US
Practice Address - Phone:818-252-5863
Practice Address - Fax:818-252-6450
Is Sole Proprietor?:No
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT 5987225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant