MEDICARE: ELAINE GABAYAN MAINS

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1396845277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE GABAYAN MAINS

Provider Business Mailing Address
First Line	:	5190 GOVERNOR DR STE 104
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-2848
Country	:	US
Telephone Number	:	858-848-5879
Fax Number	:

Provider Business Practice Location Address
First Line	:	5190 GOVERNOR DR STE 104
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-2848
Country	:	US
Telephone Number	:	858-848-5879
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/23/2024

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Directions to “ ELAINE GABAYAN MAINS ” Practice Location

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