Healthcare Provider Details

I. General information

NPI: 1699211771
Provider Name (Legal Business Name): DREW MERCER M.ED., BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 12/13/2019
Certification Date: 12/13/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41769 ENTERPRISE CIR N STE 104
TEMECULA CA
92590-5626
US

IV. Provider business mailing address

41769 ENTERPRISE CIR N STE 104
TEMECULA CA
92590-5626
US

V. Phone/Fax

Practice location:
  • Phone: 951-303-8255
  • Fax:
Mailing address:
  • Phone: 951-303-8255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: