Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ASW62526 | CA |
N | 1041C0700X | Clinical Social Worker | ASW62526 | CA |
NPI | 1003169954 |
---|---|
Provider Name | Sonia Elena Mays |
First Address | San Bruno, CA 94066-5531 |
Second Address | San Mateo, CA 94403-1269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 07/11/2014 |