Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 14598 | CA |
N | 225XM0800X | Mental Health | 14598 | CA |
NPI | 1427531599 |
---|---|
Provider Name | Maia Cubos |
First Address | Pasadena, CA 91107-3439 |
Second Address | Pasadena, CA 91107-3439 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2018 |
Last Update Date | 13/05/2020 |