Provider Demographics
NPI:1528587151
Name:MAUZE, ANISHA (MFT-I IMF 100594)
Entity Type:Individual
Prefix:
First Name:ANISHA
Middle Name:
Last Name:MAUZE
Suffix:
Gender:F
Credentials:MFT-I IMF 100594
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 WILLOW PASS RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-5292
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1320 WILLOW PASS RD STE 600
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5292
Practice Address - Country:US
Practice Address - Phone:925-532-3510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA42387OtherLMFT