Provider Demographics
NPI:1962792226
Name:MAKI, ALIYA VICTORIA (MS)
Entity type:Individual
Prefix:MRS
First Name:ALIYA
Middle Name:VICTORIA
Last Name:MAKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 S SAN PEDRO ST
Mailing Address - Street 2:APT #556
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3966
Mailing Address - Country:US
Mailing Address - Phone:909-969-4853
Mailing Address - Fax:
Practice Address - Street 1:5284 ADOLFO RD
Practice Address - Street 2:STE 100
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-6787
Practice Address - Country:US
Practice Address - Phone:775-688-1612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor