Healthcare Provider Details

I. General information

NPI: 1376497990
Provider Name (Legal Business Name): MONICA MADRIGAL SUDRC#24484
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2026
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MARKET ST FL 1
SAN FRANCISCO CA
94103-1589
US

IV. Provider business mailing address

4520 MONTGOMERY ST APT 2
OAKLAND CA
94611-4230
US

V. Phone/Fax

Practice location:
  • Phone: 415-862-2810
  • Fax:
Mailing address:
  • Phone: 510-575-2553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: