Provider Demographics
NPI:1144737842
Name:MCAULIFFE, MAURA KANE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:KANE
Last Name:MCAULIFFE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MAURA
Other - Middle Name:
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:3021 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-2329
Mailing Address - Country:US
Mailing Address - Phone:951-255-3539
Mailing Address - Fax:
Practice Address - Street 1:8253 WHITE OAK AVE
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7671
Practice Address - Country:US
Practice Address - Phone:909-987-1997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist