Healthcare Provider Details
I. General information
NPI: 1093904781
Provider Name (Legal Business Name): JEAN MAURIELLO GERMAIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/17/2007
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
211 E 7TH ST STE 620
AUSTIN TX
78701-3218
US
IV. Provider business mailing address
1 CALIFORNIA ST STE 2300
SAN FRANCISCO CA
94111-5424
US
V. Phone/Fax
- Phone: 800-997-6196
- Fax:
- Phone: 800-997-6196
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 33371 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | 33371 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 33371 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TP2701X |
| Taxonomy | Group Psychotherapy Psychologist |
| License Number | 33371 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: