Basic Information
| Provider Information | |||||||||
| NPI: | 1184048126 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAHER | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | KAYE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6860 | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955026860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074433384 | ||||||||
| FaxNumber: | 7074433204 | ||||||||
| Practice Location | |||||||||
| Address1: | 2910 HARRIS ST | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955034811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074433384 | ||||||||
| FaxNumber: | 7074433204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2014 | ||||||||
| LastUpdateDate: | 02/16/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS 60833 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.