Provider Demographics
NPI:1326712456
Name:MAAYEH, ASMAHAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ASMAHAN
Middle Name:
Last Name:MAAYEH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 FAIRFIELD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-2067
Mailing Address - Country:US
Mailing Address - Phone:650-922-3832
Mailing Address - Fax:
Practice Address - Street 1:255 N LINCOLN ST STE A
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:CA
Practice Address - Zip Code:95620-3238
Practice Address - Country:US
Practice Address - Phone:707-366-5246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31348235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist