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NPI Code Detail

MEDICARE: DR. JUNE HENDERSON MAYES PSY.D.

MEDICARE: DR. JUNE HENDERSON MAYES PSY.D.
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
1103TC0700XClinical Psychologist13494CA

General Provider Information

NPI Number : 1255833596
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUNE HENDERSON MAYES PSY.D.
Provider Business Mailing Address
First Line : 2444 WILSHIRE BLVD STE 400
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-5810
Country : US
Telephone Number : 310-998-1126
Fax Number :
Provider Business Practice Location Address
First Line : 2444 WILSHIRE BLVD STE 400
Second Line :
City : SANTA MONICA
State : CA
Zip : 90403-5810
Country : US
Telephone Number : 310-998-1126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2018
Last Update Date : 03/02/2018

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