Healthcare Provider Details

I. General information

NPI: 1366389264
Provider Name (Legal Business Name): ALAN MERCADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9165 WESTMINSTER AVE
GARDEN GROVE CA
92844-2704
US

IV. Provider business mailing address

9165 WESTMINSTER AVE
GARDEN GROVE CA
92844-2704
US

V. Phone/Fax

Practice location:
  • Phone: 714-925-6820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95289847
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: