Mercie Vanessa Acosta
Individual provider Active NPI Peer Specialist · Perris, CA
NPI 1114792124 · NPPES record last updated Jan 5, 2024
Key facts
- NPI
- 1114792124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- MPSS-MSLPJK (CA)
- Practice address
- 450 E San Jacinto Ave
Perris, CA 92571-2833 - Phone
- (951) 715-5040
- NPI assigned
- Nov 20, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-MSLPJK | CA | MD | Peer Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | |||
| Peer Specialist | 175T00000X | MPSS-MSLPJK | CA | Yes |
Addresses
Primary practice location
450 E San Jacinto Ave
Perris, CA 92571-2833
Mailing address
450 E San Jacinto Ave
Perris, CA 92571-2833
Phone (951) 715-5040
Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.