Provider Demographics
NPI:1093993305
Name:ACEVES, MARIA O (CPHW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:O
Last Name:ACEVES
Suffix:
Gender:F
Credentials:CPHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 W 17TH ST
Mailing Address - Street 2:SUITE101
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-3455
Mailing Address - Country:US
Mailing Address - Phone:714-500-0340
Mailing Address - Fax:714-500-0341
Practice Address - Street 1:1227 W 17TH ST
Practice Address - Street 2:SUITE101
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-3455
Practice Address - Country:US
Practice Address - Phone:714-500-0340
Practice Address - Fax:714-500-0341
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker