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General NPI Number Information
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NPI Number | 1679073886
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Entity Type | Individual
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Provider Name | MAIRA KESSLER CADCII
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Gender | Female
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 900 E GILBERT STE
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City | SAN BERNARDINO
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State | CA
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Zip | 92415-0001
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Country | US
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Telephone | 900-387-7406
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Fax |
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Provider Business Mailing Address
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Address Line | 900 E GILBERT ST STE 4
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City | SAN BERNARDINO
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State | CA
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Zip | 92415-0936
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Country | US
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Telephone | 909-387-7406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | A066120325
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11958
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License Number State | CA
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