Provider Demographics
NPI:1578750071
Name:MALDONADO, ANN MARIE (MA)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MARIE
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MOZDEN LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-3379
Mailing Address - Country:US
Mailing Address - Phone:925-348-4788
Mailing Address - Fax:
Practice Address - Street 1:1039 OAKPOINT DR
Practice Address - Street 2:
Practice Address - City:BAY POINT
Practice Address - State:CA
Practice Address - Zip Code:94565-7620
Practice Address - Country:US
Practice Address - Phone:925-642-5677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist