Provider Demographics
NPI:1043486368
Name:IZQUIERDO, MARIA S (CADC - II)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:S
Last Name:IZQUIERDO
Suffix:
Gender:F
Credentials:CADC - II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:115 TERRAINE ST
Mailing Address - Street 2:SECOND FLOOR, WAITING ROOM # 2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95110-2423
Mailing Address - Country:US
Mailing Address - Phone:408-491-4723
Mailing Address - Fax:408-491-4895
Practice Address - Street 1:115 TERRAINE ST
Practice Address - Street 2:SECOND FLOOR, WAITING ROOM # 2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95110-2423
Practice Address - Country:US
Practice Address - Phone:408-491-4723
Practice Address - Fax:408-491-4895
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)