Provider Demographics
NPI:1255833596
Name:MAYES, JUNE HENDERSON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JUNE
Middle Name:HENDERSON
Last Name:MAYES
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 1:2444 WILSHIRE BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5810
Mailing Address - Country:US
Mailing Address - Phone:310-998-1126
Mailing Address - Fax:
Practice Address - Street 1:2444 WILSHIRE BLVD STE 400
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5810
Practice Address - Country:US
Practice Address - Phone:310-998-1126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-02
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13494103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical