Provider Demographics
NPI:1285791426
Name:MAYFIELD-STONE, ROXIE MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ROXIE
Middle Name:MARIE
Last Name:MAYFIELD-STONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ROXIE
Other - Middle Name:MARIE
Other - Last Name:MAYFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3600 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5730
Mailing Address - Country:US
Mailing Address - Phone:510-752-1447
Mailing Address - Fax:510-752-1404
Practice Address - Street 1:3505 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5714
Practice Address - Country:US
Practice Address - Phone:510-752-1447
Practice Address - Fax:510-752-1404
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 6732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical