Provider Demographics
NPI:1598357501
Name:SLEIMAN, MAYA KERBAGE (RD)
Entity Type:Individual
Prefix:MRS
First Name:MAYA
Middle Name:KERBAGE
Last Name:SLEIMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19800 VALLCO PKWY UNIT 346
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-7115
Mailing Address - Country:US
Mailing Address - Phone:309-339-6393
Mailing Address - Fax:
Practice Address - Street 1:730 WELCH RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1503
Practice Address - Country:US
Practice Address - Phone:650-497-8263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041774133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered