Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY22157 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY22157 | CA |
NPI | 1003056680 |
---|---|
Provider Name | Dr. Maggie J Ateia |
First Address | Glendora, CA 91741-4606 |
Second Address | Glendora, CA 91740-4335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 23/02/2009 |