Tina Marie Maynard
Day Training/Habilitation Specialist in San Bernardino, CA. Individual provider (NPI-1).
NPI number1316625809
StatusActive
Last updated in NPPESApr 15, 2025
Details
- NPI
- 1316625809
- Entity type
- Individual (NPI-1)
- Name
- Tina Marie Maynard
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 6, 2023
- Certification date
- Apr 15, 2025
- Last updated
- Apr 15, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 373H00000X | Day Training/Habilitation Specialist | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | CA | |
| 172V00000X | Community Health Worker | – | – | |
| 172V00000X | Community Health Worker | – | CA |
Practice location
290 N D St Ste 700San Bernardino, CA 92401-1705
Phone 909-963-5355
Mailing address
290 N D StSan Bernardino, CA 92401-1734
Phone 909-963-5355
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 152 Day Training/Habilitation Specialist providers in San Bernardino · All 7,202 providers in San Bernardino
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