Provider Demographics
NPI:1194026096
Name:RING, MAVIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MAVIS
Middle Name:
Last Name:RING
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 N SANTA CRUZ AVE # 309
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5300
Mailing Address - Country:US
Mailing Address - Phone:408-694-7602
Mailing Address - Fax:
Practice Address - Street 1:870 MARKET ST STE 875
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-2910
Practice Address - Country:US
Practice Address - Phone:415-391-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY30355103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical