Provider Demographics
NPI:1457853194
Name:MAAZ, JENAN MUHIEDDINE
Entity Type:Individual
Prefix:
First Name:JENAN
Middle Name:MUHIEDDINE
Last Name:MAAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 SARATOGA AVE UNIT 312
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-7317
Mailing Address - Country:US
Mailing Address - Phone:408-309-3353
Mailing Address - Fax:408-309-3353
Practice Address - Street 1:150 SARATOGA AVE UNIT 312
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7317
Practice Address - Country:US
Practice Address - Phone:408-309-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-07
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist