Danessa Iza Mayo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY29622 Issued in CA

Practice address

3893 Fiano CMN
Fremont, CA 94555-2280

Phone

(510) 497-0478

NPI assigned

Nov 4, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• My Good Brain Inc

  • Community/Behavioral Health Agency
  • Fremont, CA
  • NPI 1437844842
  NPD
• Dr. Danessa Mayo, PHD

  • Clinical Psychologist
  • San Jose, CA
  • NPI 1942762299
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1043615073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3893 FIANO CMN",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3893 FIANO CMN",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945552280",
            "telephone_number": "510-497-0478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2230 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958171353",
            "country_code": "US",
            "telephone_number": "916-734-4149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1190 Lincoln Ave Ste 7",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951253036",
            "country_code": "US",
            "telephone_number": "323-909-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5838 Edison Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920085520",
            "country_code": "US",
            "telephone_number": "760-300-3664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYO",
        "first_name": "DANESSA IZA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-04",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "29622",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY29622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "D6949774",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah L. Maxwell, MD
• Vaneza Maxwell
• Ryan Hermosura May
• Maya Sastry
• Neeraja Sivasankari Mayalagu, DDS
• Courtney Elizabeth Mays
• Maria Maribel Mazariego, COTA
• Matin S. Mazidi, MD
• Tina Szeto McAdams, P.T.
• Colleen Alice McCall, BCAT, RBT

• Clinical Psychologist in Fremont, CA
• Providers in Fremont, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.