Provider Demographics
NPI:1487828810
Name:PACLEBAR MAHONEY, ANNE MARIE ROSE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNE MARIE
Middle Name:ROSE
Last Name:PACLEBAR MAHONEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ANNE MARIE
Other - Middle Name:ROSE
Other - Last Name:PACLEBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2100 NAPA VALLEJO HWY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6293
Mailing Address - Country:US
Mailing Address - Phone:707-258-3245
Mailing Address - Fax:707-253-5097
Practice Address - Street 1:2100 NAPA VALLEJO HWY
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6293
Practice Address - Country:US
Practice Address - Phone:707-258-3245
Practice Address - Fax:707-253-5097
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic