Provider Demographics
NPI:1396554838
Name:MALDONADO-PLASCENCIA, MARY DENISE (LCSW)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:DENISE
Last Name:MALDONADO-PLASCENCIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:
Other - Last Name:MALDONADO-PLASCENCIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:18543 YORBA LINDA BLVD # 252
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4135
Mailing Address - Country:US
Mailing Address - Phone:714-231-2776
Mailing Address - Fax:
Practice Address - Street 1:20071 AVENIDA DEL NORTE
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-2903
Practice Address - Country:US
Practice Address - Phone:714-231-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical