Provider Demographics
NPI:1427581974
Name:SEDILLO-GLATT, MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SEDILLO-GLATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 SILVER CREEK VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95138-1059
Mailing Address - Country:US
Mailing Address - Phone:408-363-3000
Mailing Address - Fax:
Practice Address - Street 1:5855 SILVER CREEK VALLEY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1059
Practice Address - Country:US
Practice Address - Phone:408-363-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711491041C0700X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251C00000XAgenciesDay Training, Developmentally Disabled Services