Provider Demographics
NPI:1467323998
Name:ELMORE, MERCEDES PATRICE
Entity type:Individual
Prefix:MRS
First Name:MERCEDES
Middle Name:PATRICE
Last Name:ELMORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4542 OCEAN LN
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-2557
Mailing Address - Country:US
Mailing Address - Phone:916-868-8425
Mailing Address - Fax:
Practice Address - Street 1:4542 OCEAN LN
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-2557
Practice Address - Country:US
Practice Address - Phone:916-868-8425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty