Provider Demographics
NPI:1134092646
Name:TAVERA TREJO, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TAVERA TREJO
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 1:112 ABERDEEN PL
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-4889
Mailing Address - Country:US
Mailing Address - Phone:540-607-2338
Mailing Address - Fax:
Practice Address - Street 1:112 ABERDEEN PL
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-4889
Practice Address - Country:US
Practice Address - Phone:540-607-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide