Provider Demographics
NPI:1295761682
Name:MERCY, HELENA ELAINE (PHD)
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:ELAINE
Last Name:MERCY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 PASEO LUNAR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5962
Mailing Address - Country:US
Mailing Address - Phone:805-312-4019
Mailing Address - Fax:
Practice Address - Street 1:1000 NEWBURY RD
Practice Address - Street 2:#240
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-6435
Practice Address - Country:US
Practice Address - Phone:805-312-4019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12993103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist