Provider Demographics
NPI:1073845665
Name:ROSS, MAUREEN ELIZABETH (LMFT)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ELIZABETH
Last Name:ROSS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 THE ALAMEDA STE 130
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1700
Mailing Address - Country:US
Mailing Address - Phone:408-425-7457
Mailing Address - Fax:
Practice Address - Street 1:1885 THE ALAMEDA STE 130
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1700
Practice Address - Country:US
Practice Address - Phone:408-425-7457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45280106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist