Mercedes D Green, PH.D.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

123958 Issued in CA

Practice address

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

Phone

(442) 243-2714

NPI assigned

Feb 1, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• True Escape Marriage and Family Therapy, Professional Corporation

  • Public Health or Welfare Agency
  • Victorville, CA
  • NPI 1043977945
  NPD Authorized official
• Nationwide Medical Group, Inc

  • Community Health Clinic/Center
  • Stockton, CA
  • NPI 1548317951
  NPD (past)
• Valley Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Downey, CA
  • NPI 1396491973
  NPD (past)
• Valley Star Behavioral Health, Inc.

  • Licensed Psychiatric Technician
  • Colton, CA
  • NPI 1558849141
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1679071971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8958 SVL BOX",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955132",
            "telephone_number": "951-801-0119",
            "fax_number": "442-327-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13261 SPRING VALLEY PRKWY",
            "address_2": "#203",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923955132",
            "telephone_number": "442-243-2714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11776 Mariposa Rd",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451622",
            "country_code": "US",
            "telephone_number": "760-956-2462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11776 Mariposa Rd",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451622",
            "country_code": "US",
            "telephone_number": "760-956-2462",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12188 Hesperia Rd",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "92395",
            "country_code": "US",
            "telephone_number": "760-477-2199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11951 Hesperia Rd",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923451855",
            "country_code": "US",
            "telephone_number": "760-956-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16501 Walnut St",
            "address_purpose": "LOCATION",
            "city": "Hesperia",
            "state": "CA",
            "postal_code": "923453641",
            "country_code": "US",
            "telephone_number": "760-949-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13416 Fawncreek St",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923958663",
            "country_code": "US",
            "telephone_number": "442-243-2714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MERCEDES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2024-09-06",
        "certification_date": "2024-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108857",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123958",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greater Good Health PC Inc
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• Green First Medical Group Gu'S Chinese Acupuncture
• Green Med Trans, Inc.
• Green Tree Residence LLC
• Monika Green
• Sonya N Green
• Syreeta Green, LMFT
• Jahsaan Greene
• Sophia Greene

• Marriage & Family Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.