Provider Demographics
NPI:1114400967
Name:MAYOYO, MARILYNN B (MS, APRN, NP, CNS)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:B
Last Name:MAYOYO
Suffix:
Gender:F
Credentials:MS, APRN, NP, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 BERGER AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4203
Mailing Address - Country:US
Mailing Address - Phone:858-244-6800
Mailing Address - Fax:858-244-6809
Practice Address - Street 1:3131 BERGER AVE STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4203
Practice Address - Country:US
Practice Address - Phone:858-244-6800
Practice Address - Fax:858-244-6800
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009825363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner