Individual provider Active NPI

Maiya Corrine Bertrand, LCSW

  • Clinical Social Worker
  • Fullerton, CA
National Provider Identifier
1326679770
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
136221 Issued in CA
Practice address
1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644
Phone
(714) 446-5590
Fax
(714) 446-5592
NPI assigned
Feb 3, 2020
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 136221 CA Primary

Addresses

Primary practice location

1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644

Mailing address

1950 Sunny Crest Dr Ste 2600
Fullerton, CA 92835-3644
Phone (714) 446-5590

Other practice location 1

222 S Harbor Blvd Ste 650
Anaheim, CA 92805-3756
Phone (714) 871-5646 ext. 4260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
136221CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Youth Services CurrentSince Jul 1, 2023 Accepting new patients

Locations

222 S Harbor Blvd
Ste 650
Anaheim, CA 92805
Phone (714) 871-5646

505 N Euclid St
Ste 300
Anaheim, CA 92801
Phone (714) 871-5646

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1326679770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2600",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353644",
            "telephone_number": "714-446-5590",
            "fax_number": "714-446-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SUNNY CREST DR STE 2600",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353644",
            "telephone_number": "714-446-5590",
            "fax_number": "714-446-5592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 S Harbor Blvd Ste 650",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928053756",
            "country_code": "US",
            "telephone_number": "714-871-5646 x4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERTRAND",
        "first_name": "MAIYA",
        "middle_name": "CORRINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-03",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "136221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.