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NPI Code Detail

MEDICARE: MAYA J PETERS LCSW

MEDICARE: MAYA J PETERS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerASW 30707CA
21041C0700XClinical Social WorkerLCSW94834CA

General Provider Information

NPI Number : 1982912408
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYA J PETERS LCSW
Provider Business Mailing Address
First Line : 12240 NORINO DR
Second Line :
City : WHITTIER
State : CA
Zip : 90601-2304
Country : US
Telephone Number : 626-267-2789
Fax Number :
Provider Business Practice Location Address
First Line : 6080 CENTER DR FL 6
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-9205
Country : US
Telephone Number : 626-267-2789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2010
Last Update Date : 02/24/2023

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