Provider Demographics
NPI:1710218755
Name:MA, MAGGIE LEUNG (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:MAGGIE
Middle Name:LEUNG
Last Name:MA
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MISS
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:LEUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5694 MISSION CENTER RD
Mailing Address - Street 2:SUITE 602 PMB 341
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4355
Mailing Address - Country:US
Mailing Address - Phone:510-213-8583
Mailing Address - Fax:619-220-0215
Practice Address - Street 1:5694 MISSION CENTER RD
Practice Address - Street 2:SUITE 602 PMB 341
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4355
Practice Address - Country:US
Practice Address - Phone:510-213-8583
Practice Address - Fax:619-220-0215
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-10-7416103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst