Healthcare Provider Details

I. General information

NPI: 1144648403
Provider Name (Legal Business Name): AMBER MERCADER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 30TH ST STE 412
OAKLAND CA
94609-3303
US

IV. Provider business mailing address

411 30TH ST STE 412
OAKLAND CA
94609-3303
US

V. Phone/Fax

Practice location:
  • Phone: 415-890-3815
  • Fax:
Mailing address:
  • Phone: 415-890-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number107982
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: