Active NPI
Mayalen Mercado
- Physician Assistant
- Santa Ana, CA
National Provider Identifier
1750092052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA66627
- Practice address
- 1206 E 17TH St
Santa Ana, CA 92701-2641 - Phone
- (714) 352-2911
- Fax
- (714) 352-2903
- NPI assigned
- Dec 7, 2022
- Last updated
- Sep 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA66627 | CA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
1206 E 17TH St
Santa Ana, CA 92701-2641
Mailing address
1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641
Phone (760) 975-2631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251021000996 | CA | Order and Referring Only - Physician Assistant | 6507354701 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66627 | CA | MD | Massage Therapist |
| PA66627 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1750092052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 E 17TH ST STE 101",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927012641",
"telephone_number": "760-975-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1206 E 17TH ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927012641",
"telephone_number": "714-352-2911",
"fax_number": "714-352-2903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERCADO",
"first_name": "MAYALEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-07",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA66627",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.