Provider Demographics
NPI:1316334956
Name:NAUGHTON, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:NAUGHTON
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 1:2525 CALIFORNIA ST
Mailing Address - Street 2:# 206
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2615
Mailing Address - Country:US
Mailing Address - Phone:415-205-4894
Mailing Address - Fax:
Practice Address - Street 1:2525 CALIFORNIA ST
Practice Address - Street 2:# 206
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2615
Practice Address - Country:US
Practice Address - Phone:415-205-4894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15520225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist