Healthcare Provider Details

I. General information

NPI: 1053091488
Provider Name (Legal Business Name): MADILLENE WESTERN ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 N SANBORN RD
SALINAS CA
93905-2220
US

IV. Provider business mailing address

PO BOX 85
MOSS LANDING CA
95039-0085
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-8585
  • Fax:
Mailing address:
  • Phone: 760-583-3585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: