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General NPI Number Information
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NPI Number | 1720597271
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Entity Type | Individual
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Provider Name | CYNTHIA ANN MAYNE LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 212 ASHBURY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-2025
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Country | US
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Telephone | 415-775-6194
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 STONERIDGE MALL ROAD SUITE 315
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City | CASTRO VALLEY
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State | CA
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Zip | 94102-5144
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Country | US
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Telephone | 707-761-3385
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APCC
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License Number State | CA
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