Healthcare Provider Details

I. General information

NPI: 1174456370
Provider Name (Legal Business Name): MISS MADELINE ENGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 E BADILLO ST
COVINA CA
91723-2803
US

IV. Provider business mailing address

4009 UNION AVE
BAKERSFIELD CA
93305-2459
US

V. Phone/Fax

Practice location:
  • Phone: 626-974-7000
  • Fax:
Mailing address:
  • Phone: 661-327-7025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW131668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: