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General NPI Number Information
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NPI Number | 1750001707
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Entity Type | Individual
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Provider Name | MAXWELL PAUL MYERS
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Gender | Male
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Dates
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Enumeration Date | 08/30/2022
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 5201 GREAT AMERICA PKWY STE 320
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City | SANTA CLARA
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State | CA
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Zip | 95054-1140
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Country | US
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Telephone | 323-205-7088
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Fax | 833-419-0181
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Provider Business Mailing Address
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Address Line | 12350 DEL AMO BLVD APT 806
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City | LAKEWOOD
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State | CA
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Zip | 90715-1740
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Country | US
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Telephone | 760-500-0653
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19008
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License Number State | CA
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