Healthcare Provider Details
I. General information
NPI: 1003441213
Provider Name (Legal Business Name): REEMA M MAAYAA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/08/2020
Last Update Date: 03/08/2020
Certification Date: 03/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 VAN HOUTEN AVE
EL CAJON CA
92020-5128
US
IV. Provider business mailing address
21600 OXNARD ST STE 1800
WOODLAND HILLS CA
91367-7807
US
V. Phone/Fax
- Phone: 619-383-0704
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: