Provider Demographics
NPI:1831715333
Name:MALDONADO, VICTOR I
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:MALDONADO
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BIRMINGHAM DR STE 240A
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-1757
Mailing Address - Country:US
Mailing Address - Phone:760-655-6914
Mailing Address - Fax:858-381-9768
Practice Address - Street 1:120 BIRMINGHAM DR STE 240A
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:CA
Practice Address - Zip Code:92007-1757
Practice Address - Country:US
Practice Address - Phone:760-655-6914
Practice Address - Fax:858-381-9768
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty