Healthcare Provider Details

I. General information

NPI: 1285819649
Provider Name (Legal Business Name): MELISSA ANN MERCER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2008
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 S ATLANTIC BLVD SUITE #101
COMMERCE CA
90040-1200
US

IV. Provider business mailing address

21545 CENTRE POINTE PKWY
SANTA CLARITA CA
91350-2947
US

V. Phone/Fax

Practice location:
  • Phone: 323-318-9960
  • Fax: 323-780-3211
Mailing address:
  • Phone: 661-259-9439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26333
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: