Provider Demographics
NPI:1437308905
Name:NEWMAN, MAIA J (MS, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MAIA
Middle Name:J
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 SIR FRANCIS DRAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1427
Mailing Address - Country:US
Mailing Address - Phone:415-721-4373
Mailing Address - Fax:
Practice Address - Street 1:1036 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-1427
Practice Address - Country:US
Practice Address - Phone:415-721-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW#181231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical