Provider Demographics
NPI:1801789417
Name:SLISCO, MAIJA KAI (MSW)
Entity type:Individual
Prefix:
First Name:MAIJA
Middle Name:KAI
Last Name:SLISCO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27922 CAPTIVA PL
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-4824
Mailing Address - Country:US
Mailing Address - Phone:760-972-6110
Mailing Address - Fax:
Practice Address - Street 1:27922 CAPTIVA PL
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-4824
Practice Address - Country:US
Practice Address - Phone:760-972-6110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker