Provider Demographics
NPI:1598897555
Name:WAAS, PAULINA (MS)
Entity Type:Individual
Prefix:MRS
First Name:PAULINA
Middle Name:
Last Name:WAAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:PAULINA
Other - Last Name:SOARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:17080 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-1100
Mailing Address - Country:US
Mailing Address - Phone:760-895-2837
Mailing Address - Fax:
Practice Address - Street 1:20601 US HIGHWAY 18
Practice Address - Street 2:SUITE 109
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-3567
Practice Address - Country:US
Practice Address - Phone:760-240-4567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 53823106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist