Healthcare Provider Details

I. General information

NPI: 1508927104
Provider Name (Legal Business Name): LAUREN G. MAI PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 BALBOA ST
SAN FRANCISCO CA
94121-2569
US

IV. Provider business mailing address

4020 BALBOA ST
SAN FRANCISCO CA
94121-2569
US

V. Phone/Fax

Practice location:
  • Phone: 415-668-5998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY26280
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: