Provider Demographics
NPI:1356172704
Name:HINES, MARYANN R
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:R
Last Name:HINES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARYANN
Other - Middle Name:
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 ALLERTON ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1519
Mailing Address - Country:US
Mailing Address - Phone:650-599-9955
Mailing Address - Fax:
Practice Address - Street 1:500 ALLERTON ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1519
Practice Address - Country:US
Practice Address - Phone:650-599-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)