Healthcare Provider Details

I. General information

NPI: 1932932134
Provider Name (Legal Business Name): MAYA EVA KECES RN, MS, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2024
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12495 VALLEY VIEW ST
GARDEN GROVE CA
92845-2032
US

IV. Provider business mailing address

12495 VALLEY VIEW ST
GARDEN GROVE CA
92845-2032
US

V. Phone/Fax

Practice location:
  • Phone: 714-897-9355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95031150
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: