| Mercedes Canizalez | |
|
1720 E 21st St San Bernardino CA 92404-5619 | |
| (909) 294-6353 | |
| Not Available |
| Full Name | Mercedes Canizalez |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1720 E 21st St, San Bernardino, California |
| Authorized Official Name and Position | Mercedes Canizalez (SOLE OWNER) |
| Authorized Official Contact | 9092946353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercedes Canizalez 1663 E Date Pl # 3152 San Bernardino CA 92404-4496 Ph: (909) 294-6353 | Mercedes Canizalez 1720 E 21st St San Bernardino CA 92404-5619 Ph: (909) 294-6353 |
| NPI Number | 1356119408 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356119408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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