Healthcare Provider Details

I. General information

NPI: 1497279129
Provider Name (Legal Business Name): MADONNA MARGARET NAVARRO LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADONNA MOBLEY

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 CANYON DEL REY BLVD # 1062
SEASIDE CA
93955-3501
US

IV. Provider business mailing address

1550 CANYON DEL REY BLVD # 1062
SEASIDE CA
93955-3501
US

V. Phone/Fax

Practice location:
  • Phone: 831-295-5784
  • Fax:
Mailing address:
  • Phone: 831-295-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number124660
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF99381
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: