Healthcare Provider Details

I. General information

NPI: 1235454752
Provider Name (Legal Business Name): MARIALUISA MADERA-DIGIUSEPPE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 10/24/2021
Certification Date: 10/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 E 6TH ST
LOS ANGELES CA
90021-1026
US

IV. Provider business mailing address

41 E FOOTHILL BLVD STE 102
ARCADIA CA
91006-2361
US

V. Phone/Fax

Practice location:
  • Phone: 213-623-8446
  • Fax: 213-896-1880
Mailing address:
  • Phone: 626-737-1103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29887
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: