Healthcare Provider Details

I. General information

NPI: 1568380244
Provider Name (Legal Business Name): GATEWAY TO PERINATAL SERVICES FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22373 BLUE LUPINE CIR
GRAND TERRACE CA
92313-5466
US

IV. Provider business mailing address

22373 BLUE LUPINE CIR
GRAND TERRACE CA
92313-5466
US

V. Phone/Fax

Practice location:
  • Phone: 661-889-2411
  • Fax:
Mailing address:
  • Phone: 661-889-2411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MARY M MERCER
Title or Position: PRESIDENT
Credential:
Phone: 661-889-2411