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General NPI Number Information
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NPI Number | 1376866368
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Entity Type | Individual
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Provider Name | JEANETTE ELAINE MAYHEW LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2010
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 920 SARATOGA AVE SUITE 212
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City | SAN JOSE
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State | CA
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Zip | 95129-3403
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Country | US
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Telephone | 408-793-0183
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Fax | 408-249-9240
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Provider Business Mailing Address
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Address Line | 920 SARATOGA AVENUE SUITE 212
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City | SAN JOSE
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State | CA
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Zip | 95129-3408
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Country | US
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Telephone | 408-793-0183
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Fax | 408-249-9240
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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 | LCS17437
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License Number State | CA
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