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NPI Code Detail

MEDICARE: DESTINY M MALDONADO

MEDICARE: DESTINY M MALDONADO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1285254235
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY M MALDONADO
Provider Business Mailing Address
First Line : 201 N BRAND BLVD OFC 233
Second Line :
City : GLENDALE
State : CA
Zip : 91203-3588
Country : US
Telephone Number : 818-722-1770
Fax Number : 855-568-2494
Provider Business Practice Location Address
First Line : 201 N BRAND BLVD OFC 233
Second Line :
City : GLENDALE
State : CA
Zip : 91203-3588
Country : US
Telephone Number : 818-722-1770
Fax Number : 855-568-2494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2020
Last Update Date : 06/16/2023

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Directions to “ DESTINY M MALDONADO ” Practice Location

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