Alexander Mayer, LCSW | |
1733 Skillman Ln, Petaluma, CA 94952-1250 | |
(510) 910-9675 | |
Not Available |
Full Name | Alexander Mayer |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1733 Skillman Ln, Petaluma, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063088185 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 1131040-3501 (Utah) | Secondary |
101YM0800X | Counselor - Mental Health | 103339 (California) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
---|---|
Alexander Mayer, LCSW 3805 S 900 E Unit 1, Salt Lake City, UT 84106-1932 Ph: (510) 910-9675 | Alexander Mayer, LCSW 1733 Skillman Ln, Petaluma, CA 94952-1250 Ph: (510) 910-9675 |
Kelsey Gielen, Counselor Medicare: Not Enrolled in Medicare Practice Location: 365 Kuck Ln, Petaluma, CA 94952 Phone: 707-795-6954 | |
Kati Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3539 Skillman Ln, Petaluma, CA 94952 Phone: 707-765-6555 | |
Kaitlyn D Henris, Counselor Medicare: Not Enrolled in Medicare Practice Location: 5350 Old Redwood Hwy, Suite 600, Petaluma, CA 94954 Phone: 707-565-1270 | |
Gary Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3539 Skillman Ln, Petaluma, CA 94952 Phone: 707-765-6555 | |
Erin Ellen Ahern, CAS Counselor Medicare: Not Enrolled in Medicare Practice Location: 1355 Industrial Ave, Petaluma, CA 94952 Phone: 707-776-4670 Fax: 707-544-9011 | |
Kyle Lew, Counselor Medicare: Not Enrolled in Medicare Practice Location: 365 Kuck Ln, Petaluma, CA 94952 Phone: 707-795-6954 | |
Stephen Donnellan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 365 Kuck Ln, Petaluma, CA 94952 Phone: 707-795-6954 |