Provider Demographics
NPI:1639687510
Name:MAYA, BRENDA NOEMI
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:NOEMI
Last Name:MAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:NOEMI
Other - Last Name:ALEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:7551 CLEVELAND-GIBBS RD
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:951-663-2843
Mailing Address - Fax:
Practice Address - Street 1:7551 CLEVELAND-GIBBS RD.
Practice Address - Street 2:BUILDING 1
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226
Practice Address - Country:US
Practice Address - Phone:940-319-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-13
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
CA1-18-31970103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251S00000XAgenciesCommunity/Behavioral Health