Provider Demographics
NPI:1578016564
Name:TOLEDO, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TOLEDO
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 1:1578 BLUE BONNET WAY
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-7609
Mailing Address - Country:US
Mailing Address - Phone:951-283-3190
Mailing Address - Fax:
Practice Address - Street 1:950 N RAMONA BLVD
Practice Address - Street 2:SUITE 1&2
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92582-2567
Practice Address - Country:US
Practice Address - Phone:951-487-2674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT13953171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator