Healthcare Provider Details

I. General information

NPI: 1538049168
Provider Name (Legal Business Name): BELLEN L BUENO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 10/24/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E 7TH ST
MADERA CA
93638-3780
US

IV. Provider business mailing address

209 E 7TH ST
MADERA CA
93638-3780
US

V. Phone/Fax

Practice location:
  • Phone: 559-395-0451
  • Fax: 559-661-2818
Mailing address:
  • Phone: 559-395-0451
  • Fax: 559-661-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: