Provider Demographics
NPI:1144798471
Name:FLOREZ, MARITESS (LMFT)
Entity type:Individual
Prefix:
First Name:MARITESS
Middle Name:
Last Name:FLOREZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:
Other - Last Name:FLOREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2039 FOREST AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4815
Mailing Address - Country:US
Mailing Address - Phone:408-465-0801
Mailing Address - Fax:
Practice Address - Street 1:2039 FOREST AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4815
Practice Address - Country:US
Practice Address - Phone:408-358-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT123303106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist