Healthcare Provider Details

I. General information

NPI: 1497633762
Provider Name (Legal Business Name): ANNA LEE MRAZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA LEE MRAZ BARTRA

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 SAN CARLOS AVE
SAN CARLOS CA
94070-2317
US

IV. Provider business mailing address

28 CLAREMONT AVE
REDWOOD CITY CA
94062-1712
US

V. Phone/Fax

Practice location:
  • Phone: 650-313-7522
  • Fax:
Mailing address:
  • Phone: 650-313-7522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: