Individual
MS. MARY REDEMPTA MACAVORAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
436 N WHITE RD, SAN JOSE, CA 95127-1439
(408) 269-0760
(408) 642-6052
Mailing address
1922 THE ALAMEDA STE 316, SAN JOSE, CA 95126-1461
(408) 261-7777
(408) 642-6052
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
35027
CA
Other
Enumeration date
03/06/2007
Last updated
03/28/2023
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