Healthcare Provider Details

I. General information

NPI: 1255873808
Provider Name (Legal Business Name): ELEN JOIE MERCADO MS, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1521 W CAMERON AVE STE 250
WEST COVINA CA
91790-2738
US

IV. Provider business mailing address

1521 W CAMERON AVE STE 250
WEST COVINA CA
91790-2738
US

V. Phone/Fax

Practice location:
  • Phone: 626-231-0502
  • Fax: 626-407-4779
Mailing address:
  • Phone: 626-231-0502
  • Fax: 626-407-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90953
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: