Provider Demographics
NPI:1679073886
Name:KESSLER, MAIRA (CADCII)
Entity type:Individual
Prefix:
First Name:MAIRA
Middle Name:
Last Name:KESSLER
Suffix:
Gender:F
Credentials:CADCII
Other - Prefix:
Other - First Name:MAIRA
Other - Middle Name:
Other - Last Name:KESSLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SUDCC
Mailing Address - Street 1:900 E GILBERT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92415-0936
Mailing Address - Country:US
Mailing Address - Phone:909-387-7406
Mailing Address - Fax:
Practice Address - Street 1:900 E GILBERT STE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92415-0001
Practice Address - Country:US
Practice Address - Phone:900-387-7406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-14
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA066120325101YA0400X
CA11958101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)