Healthcare Provider Details

I. General information

NPI: 1881315083
Provider Name (Legal Business Name): MARIBEL A DONA BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 E FOOTHILL BLVD
PASADENA CA
91107-3439
US

IV. Provider business mailing address

120 E MONTEREY AVE UNIT A-128
POMONA CA
91767-5420
US

V. Phone/Fax

Practice location:
  • Phone: 626-577-2261
  • Fax:
Mailing address:
  • Phone: 925-348-2609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW130669
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: