Provider Demographics
NPI:1437277530
Name:MAYER, NANCY LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LYNNE
Last Name:MAYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16720 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:PATTERSON
Mailing Address - State:CA
Mailing Address - Zip Code:95363-9724
Mailing Address - Country:US
Mailing Address - Phone:209-214-6207
Mailing Address - Fax:
Practice Address - Street 1:16720 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363-9724
Practice Address - Country:US
Practice Address - Phone:610-557-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235639207QA0505X
CAG88557207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine