Provider Demographics
NPI:1770602823
Name:PASILLAS, MARIA A
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:A
Last Name:PASILLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6811 OAKDALE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-9636
Mailing Address - Country:US
Mailing Address - Phone:209-869-4019
Mailing Address - Fax:209-869-4019
Practice Address - Street 1:6811 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:RIVERBANK
Practice Address - State:CA
Practice Address - Zip Code:95367-9636
Practice Address - Country:US
Practice Address - Phone:209-869-4019
Practice Address - Fax:209-869-4019
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health