Provider Demographics
NPI:1407055841
Name:WELLS, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:WELLS
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 1:333 N LANTANA ST STE 259
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-9008
Mailing Address - Country:US
Mailing Address - Phone:818-746-5540
Mailing Address - Fax:
Practice Address - Street 1:333 N LANTANA ST
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9010
Practice Address - Country:US
Practice Address - Phone:805-388-7740
Practice Address - Fax:805-482-0987
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist