Provider Demographics
NPI:1104668383
Name:MAESTAS, AARON (CPSW)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MAESTAS
Suffix:
Gender:M
Credentials:CPSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 CALIFORNIA ST NE # 87108
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1802
Mailing Address - Country:US
Mailing Address - Phone:505-308-8296
Mailing Address - Fax:
Practice Address - Street 1:203 CALIFORNIA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1802
Practice Address - Country:US
Practice Address - Phone:505-308-8296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2025-01-16
Deactivation Date:2024-09-27
Deactivation Code:
Reactivation Date:2025-01-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker