Provider Demographics
NPI:1144940289
Name:EMILY MAYNARD, PHD, PSYCHOLOGIST, INC.
Entity type:Organization
Organization Name:EMILY MAYNARD, PHD, PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:WOODMAN
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:914-960-8936
Mailing Address - Street 1:5276 HOLLISTER AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-3066
Mailing Address - Country:US
Mailing Address - Phone:805-229-1601
Mailing Address - Fax:
Practice Address - Street 1:5276 HOLLISTER AVE STE 205
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-3066
Practice Address - Country:US
Practice Address - Phone:805-229-1601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health