Provider Demographics
NPI:1407259518
Name:HER, MAI GEE (MA)
Entity Type:Individual
Prefix:MS
First Name:MAI
Middle Name:GEE
Last Name:HER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:MAI GEE
Other - Middle Name:
Other - Last Name:HER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:9412 BIG HORN BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-1101
Mailing Address - Country:US
Mailing Address - Phone:916-226-2812
Mailing Address - Fax:916-226-2804
Practice Address - Street 1:9412 BIG HORN BLVD STE 6
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-1101
Practice Address - Country:US
Practice Address - Phone:916-226-2812
Practice Address - Fax:916-226-2804
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF90306106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA56CCOtherASPIRA