Healthcare Provider Details

I. General information

NPI: 1841055084
Provider Name (Legal Business Name): MAYA BARAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WESTWOOD PLZ STE B7-357
LOS ANGELES CA
90024-5055
US

IV. Provider business mailing address

760 WESTWOOD PLZ STE B7-357
LOS ANGELES CA
90024-5055
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-6373
  • Fax:
Mailing address:
  • Phone: 310-825-6373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA209678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: