| Doctor Name: | SAMANTHA CHHIM MAEDA |
| NPI Number: | 1053723866 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 63150 |
| Business Practice Address: | 1331 1/2 W 168th St # B Gardena, CA - 902475509 |
| Business Phone Number: | 7143302408 |
| Business Fax Number: | |
| Mailing Address: | 1331 1/2 W 168th St # B, GARDENA |
| State: | CA |
| Postal Code: | 902475509 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2014 |
| NPI Last Update Date: | 03/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 63150 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |