Maryia Ann Agra, Behavioral Health
Rehabilitation Practitioner in San Jose, CA. Individual provider (NPI-1).
NPI number1902639339
StatusActive
Last updated in NPPESAug 15, 2025
Details
- NPI
- 1902639339
- Entity type
- Individual (NPI-1)
- Name
- Ms. Maryia Ann Agra
- Credential
- Behavioral Health
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 21, 2024
- Certification date
- Aug 15, 2025
- Last updated
- Aug 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
160 E Virginia St Ste 100San Jose, CA 95112-5865
Phone 408-938-2113 · Fax 408-579-6143
Mailing address
160 E Virginia St Ste 280San Jose, CA 95112-5817
Phone 408-938-2113 · Fax 408-579-6143
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