Healthcare Provider Details

I. General information

NPI: 1336341932
Provider Name (Legal Business Name): COUNTY OF MERCED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S N ST
MERCED CA
95340-6818
US

IV. Provider business mailing address

260 E 15TH ST
MERCED CA
95341-6216
US

V. Phone/Fax

Practice location:
  • Phone: 209-723-1891
  • Fax:
Mailing address:
  • Phone: 209-381-1200
  • Fax: 209-381-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARIA GUADALUPE CISNEROS
Title or Position: COMPLIANCE MANAGER
Credential:
Phone: 209-756-0193