Provider Demographics
NPI:1205453503
Name:FLORES, MARIA DE LOS ANGELES (AOD COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:FLORES
Suffix:
Gender:F
Credentials:AOD COUNSELOR
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:DE LOS ANGELES
Other - Last Name:PARRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1496 N BEALE RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-6205
Mailing Address - Country:US
Mailing Address - Phone:530-749-8640
Mailing Address - Fax:
Practice Address - Street 1:1496 N BEALE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-6205
Practice Address - Country:US
Practice Address - Phone:530-749-8640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)