Provider Demographics
NPI:1659843944
Name:MAESTAS, DEANNA V (MA, BCABA)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:V
Last Name:MAESTAS
Suffix:
Gender:F
Credentials:MA, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 SENAC PL NE APT 4
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-2848
Mailing Address - Country:US
Mailing Address - Phone:505-946-7761
Mailing Address - Fax:
Practice Address - Street 1:11100 SENAC PL NE APT 4
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-2848
Practice Address - Country:US
Practice Address - Phone:505-946-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM103K00000X
NM01-25-16077106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst