Provider Information for 1679173843
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MAIDA PATRICIA FERRAES LMFT
Sex: Female
NPI: 1679173843
Last Updated: 2022-12-21
Certification Date: 2022-12-21
Certification Date: 2022-12-21
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1679173843 | ||||||||
| Enumeration Date | 2020-10-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 17901 MARK LEE DR JAMUL, CA 91935-2649 United States Phone: 760-554-7455 | Fax: | ||||||||
| Primary Practice Address | 17901 MARK LEE DR JAMUL, CA 91935-2649 United States Phone: 760-554-7455 | Fax: | ||||||||
| Secondary Practice Address(es) | 17901 MARK LEE DR | ||||||||
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