Healthcare Provider Details

I. General information

NPI: 1760376131
Provider Name (Legal Business Name): BELLA M MERCADO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BELLA M MERCADO PMHNP

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 MACARTHUR BLVD ST 14B
BERKELEY CA
94606
US

IV. Provider business mailing address

1 KELTON CT APT 2A
OAKLAND CA
94611-4853
US

V. Phone/Fax

Practice location:
  • Phone: 510-981-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039684
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number64000
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: