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General NPI Number Information
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NPI Number | 1588906390
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Entity Type | Individual
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Provider Name | CONSUELO MERCE' EDWARDS MD
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Gender | Female
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 1391 FAREN DR
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City | SANTA ANA
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State | CA
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Zip | 92705-2451
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Country | US
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Telephone | 714-838-3918
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Fax | 714-838-4737
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Provider Business Mailing Address
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Address Line | 1391 FAREN DR
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City | SANTA ANA
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State | CA
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Zip | 92705-2451
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Country | US
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Telephone | 714-838-3918
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Fax | 714-838-4737
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number | CFE38754
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | CFE38754
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License Number State | CA
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