Healthcare Provider Details

I. General information

NPI: 1376897173
Provider Name (Legal Business Name): MARIA MACIEL BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 E SANTA CLARA ST
SAN JOSE CA
95116-2337
US

IV. Provider business mailing address

1245 E SANTA CLARA ST # 444
SAN JOSE CA
95116-2337
US

V. Phone/Fax

Practice location:
  • Phone: 408-240-0070
  • Fax: 408-240-0077
Mailing address:
  • Phone: 408-240-0070
  • Fax: 408-240-0077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: