Provider Demographics
NPI:1457756413
Name:MAYO, ANN M (RN; DNSC; CNS; FAAN)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:MAYO
Suffix:
Gender:F
Credentials:RN; DNSC; CNS; FAAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 VANITIE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-7038
Mailing Address - Country:US
Mailing Address - Phone:858-488-7976
Mailing Address - Fax:
Practice Address - Street 1:806 VANITIE CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-7038
Practice Address - Country:US
Practice Address - Phone:858-488-7976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-01
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA255513364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology