Individual
ADAM CHARLES MAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 398-0355
(619) 398-0352
Mailing address
1260 MORENA BLVD STE 100, SAN DIEGO, CA 92110-3850
(619) 398-0355
(619) 398-0352
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
CA
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/16/2011
Last updated
03/26/2025
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