MEDICARE: DR. MAVIS RING PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY30355	CA

General Provider Information

NPI Number	:	1194026096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAVIS RING PSYD

Provider Business Mailing Address
First Line	:	481 N SANTA CRUZ AVE # 309
Second Line	:
City	:	LOS GATOS
State	:	CA
Zip	:	95030-5300
Country	:	US
Telephone Number	:	408-694-7602
Fax Number	:

Provider Business Practice Location Address
First Line	:	870 MARKET ST STE 875
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-2910
Country	:	US
Telephone Number	:	415-391-7171
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2010
Last Update Date	:	09/01/2020

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