Provider Demographics
NPI:1588741128
Name:DE ARAUJO, MARANTHA PATTEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARANTHA
Middle Name:PATTEN
Last Name:DE ARAUJO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 RENATO CT STE 15
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-4016
Mailing Address - Country:US
Mailing Address - Phone:650-298-8581
Mailing Address - Fax:650-298-8581
Practice Address - Street 1:61 RENATO CT STE 15
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-4016
Practice Address - Country:US
Practice Address - Phone:650-298-8581
Practice Address - Fax:650-298-8581
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 29529103TC0700X
CAPSY 19519103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA80566Medicaid