Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 25601 | CA |
NPI | 1003043738 |
---|---|
Provider Name | Mrs. Gretchen Sheyna Mayer |
First Address | Westlake Village, CA 91362-4027 |
Second Address | Westlake Village, CA 91362-4027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2009 |
Last Update Date | 20/06/2009 |