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General NPI Number Information
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NPI Number | 1962792226
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Entity Type | Individual
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Provider Name | ALIYA VICTORIA MAKI M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/07/2011
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 5284 ADOLFO RD STE 100
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City | CAMARILLO
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State | CA
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Zip | 93012-6787
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Country | US
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Telephone | 775-688-1612
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Fax |
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Provider Business Mailing Address
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Address Line | 235 S SAN PEDRO ST APT #556
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City | LOS ANGELES
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State | CA
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Zip | 90012-3966
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Country | US
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Telephone | 909-969-4853
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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