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NPI Code Detail

MEDICARE: MARTHA A MADRIGAL

MEDICARE: MARTHA A MADRIGAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistIMF43117CA
2106H00000XMarriage & Family TherapistLMFT51757CA

General Provider Information

NPI Number : 1336363332
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA A MADRIGAL
Provider Business Mailing Address
First Line : 2000 ALAMEDA DE LAS PULGAS STE 200
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-1293
Country : US
Telephone Number : 650-573-3542
Fax Number : 650-341-7389
Provider Business Practice Location Address
First Line : 2000 ALAMEDA DE LAS PULGAS STE 200
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-1293
Country : US
Telephone Number : 650-573-3542
Fax Number : 650-341-7389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 04/28/2021

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Directions to “ MARTHA A MADRIGAL ” Practice Location

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