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General NPI Number Information
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NPI Number | 1245038207
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Entity Type | Individual
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Provider Name | MARYJANE CONROY LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2117 CURTNER AVE
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City | SAN JOSE
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State | CA
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Zip | 95124-1308
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Country | US
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Telephone | 657-524-1897
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 66411
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City | SCOTTS VALLEY
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State | CA
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Zip | 95067-6411
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Country | US
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Telephone | 657-524-1897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 128987
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License Number State | CA
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