Individual
MRS. AMY GERVASI MAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
205 E 3RD AVE, SAN MATEO, CA 94401-4051
(650) 438-7024
(650) 359-3161
Mailing address
205 E 3RD AVE, SAN MATEO, CA 94401-4051
(650) 438-7024
(650) 359-3161
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
40491
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80641
MEDICAL
CA
Enumeration date
01/25/2007
Last updated
07/08/2007
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