Provider Demographics
NPI:1417767849
Name:MENTAL HEALTH WITH MAYA
Entity type:Organization
Organization Name:MENTAL HEALTH WITH MAYA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MAYA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:916-549-2892
Mailing Address - Street 1:1420 RESPONSE RD APT 155
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-5241
Mailing Address - Country:US
Mailing Address - Phone:916-549-2892
Mailing Address - Fax:
Practice Address - Street 1:1420 RESPONSE RD APT 155
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-5241
Practice Address - Country:US
Practice Address - Phone:916-549-2892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health