Provider Demographics
NPI:1598098162
Name:MAYER, MINOU Z
Entity Type:Individual
Prefix:MRS
First Name:MINOU
Middle Name:Z
Last Name:MAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MINOU
Other - Middle Name:
Other - Last Name:ZARIBAF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:21448 ENTRADA RD
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3539
Mailing Address - Country:US
Mailing Address - Phone:310-455-3348
Mailing Address - Fax:
Practice Address - Street 1:21448 ENTRADA ROAD
Practice Address - Street 2:
Practice Address - City:TOPANGA
Practice Address - State:CA
Practice Address - Zip Code:90290
Practice Address - Country:US
Practice Address - Phone:310-455-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 34816106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist