Individual
JOHANNA MAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4370 ALPINE RD, SUITE 102, PORTOLA VALLEY, CA 94028-7952
(650) 851-1164
Mailing address
4370 ALPINE RD, SUITE 102, PORTOLA VALLEY, CA 94028-7952
(650) 851-1164
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY5817
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151141
VALUE OPTIONS PROVIDER #
CA
Enumeration date
02/27/2007
Last updated
06/10/2010
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