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Mercedes D Green

Marriage & Family Therapist

Behavioral Health & Social Service Providers

13261 Spring Valley Prkwy, #203, Victorville, CA 92395-5132

PECOS Enrollment

Based on the most recent information from CMS, provider Mercedes D Green does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1679071971
Provider Type
Individual
Full Name
Green, Mercedes D
Title
Dr.
Credential
PH.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
2/1/2018
Last Updated
9/6/2024

Contact Information

Practice Location

13261 Spring Valley Prkwy, #203, Victorville, CA 92395-5132

(442) 243-2714

Unlisted Fax

Mailing Location

8958 Svl Box, Victorville, CA 92395-5132

(951) 801-0119

(442) 327-9151

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 123958 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 108857 California
Code 101YA0400X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Mercedes D Green

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Cardoza, Tonii Marie

Saldana, Elena Ann

Garcia, Karena

Thomas-Torres, Tiffany Camille

Mccain, Larissa

Winderweedle, Patsy Jane

Mcnally, Zenaida Leeanne

Stutson, Shirley Ann

Bray, Craig

Prickett, Patricia Elvera