Provider Demographics
NPI:1104178011
Name:MAY, MARILYN (MS)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:MAY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MAL
Other - Middle Name:
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:14895 E 14TH ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-2922
Mailing Address - Country:US
Mailing Address - Phone:510-957-5465
Mailing Address - Fax:
Practice Address - Street 1:14895 E 14TH ST
Practice Address - Street 2:SUITE 280
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2922
Practice Address - Country:US
Practice Address - Phone:510-957-5465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor