Healthcare Provider Details

I. General information

NPI: 1912659442
Provider Name (Legal Business Name): BARBARA MAE MADRIAGA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 SANTA FE DR STE 105
ENCINITAS CA
92024-5157
US

IV. Provider business mailing address

PO BOX 4062
ALAMEDA CA
94501-0401
US

V. Phone/Fax

Practice location:
  • Phone: 760-452-3340
  • Fax:
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-421-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018367
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: