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General NPI Number Information
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NPI Number | 1407983679
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Entity Type | Individual
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Provider Name | PATRICIA ELIZABETH MAURO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5850 OBERLIN DR SUITE 102
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City | SAN DIEGO
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State | CA
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Zip | 92121-4719
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Country | US
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Telephone | 858-535-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 TORREJON PL
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City | CARLSBAD
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State | CA
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Zip | 92009-8034
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Country | US
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Telephone | 760-942-6320
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 13924
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License Number State | CA
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