Healthcare Provider Details

I. General information

NPI: 1124283957
Provider Name (Legal Business Name): MARY HELEN ESQUER MADRIGAL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2695 S 4TH ST
EL CENTRO CA
92243-6012
US

IV. Provider business mailing address

2695 S 4TH ST
EL CENTRO CA
92243-6012
US

V. Phone/Fax

Practice location:
  • Phone: 760-339-6850
  • Fax: 760-370-0946
Mailing address:
  • Phone: 760-339-6850
  • Fax: 760-370-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: