Provider Demographics
NPI:1982095030
Name:WILBUR, MAALIEA (LMFT)
Entity Type:Individual
Prefix:
First Name:MAALIEA
Middle Name:
Last Name:WILBUR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 VILLAGE LN
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7218
Mailing Address - Country:US
Mailing Address - Phone:408-508-6789
Mailing Address - Fax:408-399-8909
Practice Address - Street 1:334 VILLAGE LN
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7218
Practice Address - Country:US
Practice Address - Phone:408-508-6789
Practice Address - Fax:408-399-8909
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50995106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist