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Contact Information

MAE H CUSACK
673 SAN JOSE AVE
SAN FRANCISCO, CA94110-4914
 Phone: 415-282-3769
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
 

Behavioral Neurology & Neuropsychiatry

2084B0040X
Indicates primary specialty

NPI Profile & details for MAE H CUSACK · (Female)

NPI Number 1992396188
Status Active
Credentials
Entity Individual
Enumeration date 01/29/2021
Last updated 09/21/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 2080P0008X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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