Healthcare Provider Details

I. General information

NPI: 1609682962
Provider Name (Legal Business Name): HANNAH MAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 BLUE OAKS BLVD STE 260
ROSEVILLE CA
95747-4003
US

IV. Provider business mailing address

3136 GARIBALDI DR
ROSEVILLE CA
95747-5976
US

V. Phone/Fax

Practice location:
  • Phone: 530-887-1006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-BGRNJS
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number09576C2485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: