Healthcare Provider Details

I. General information

NPI: 1700283983
Provider Name (Legal Business Name): ARELY MERCADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E MAIN ST STE 117
BARSTOW CA
92311-2361
US

IV. Provider business mailing address

222 E MAIN ST STE 117
BARSTOW CA
92311-2365
US

V. Phone/Fax

Practice location:
  • Phone: 760-255-1496
  • Fax: 760-255-2542
Mailing address:
  • Phone: 760-255-1496
  • Fax: 760-255-2542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: