Provider Demographics
NPI:1881071975
Name:MAZIN, EFRAT M (PSYD)
Entity type:Individual
Prefix:DR
First Name:EFRAT
Middle Name:M
Last Name:MAZIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3181
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-3181
Mailing Address - Country:US
Mailing Address - Phone:559-934-3665
Mailing Address - Fax:
Practice Address - Street 1:24511 W. JAYNE STREET
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93278-3181
Practice Address - Country:US
Practice Address - Phone:559-934-3665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24503103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical