Provider Demographics
NPI:1356522072
Name:MCCARTHY, MARYBETH
Entity type:Individual
Prefix:MRS
First Name:MARYBETH
Middle Name:
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4145 BAY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4270
Mailing Address - Country:US
Mailing Address - Phone:510-226-7141
Mailing Address - Fax:510-226-7156
Practice Address - Street 1:4145 BAY ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4270
Practice Address - Country:US
Practice Address - Phone:510-226-7141
Practice Address - Fax:510-226-7156
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator