Individual
TIFFANY D MAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2110 ABBEY LN, CAMPBELL, CA 95008-3924
(408) 409-3396
Mailing address
2110 ABBEY LN, CAMPBELL, CA 95008-3924
(408) 409-3396
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
CA
175T00000X
Peer Specialist
Primary
MPSS-FNWJQK
CA
Other
Enumeration date
05/02/2024
Last updated
10/25/2024
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