Provider Demographics
NPI:1881318491
Name:FILATOFF, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:FILATOFF
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 1:420 SMILAX RD APT NO121
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-6157
Mailing Address - Country:US
Mailing Address - Phone:760-829-8165
Mailing Address - Fax:
Practice Address - Street 1:420 SMILAX RD APT NO121
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-6157
Practice Address - Country:US
Practice Address - Phone:760-829-8165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13831101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)