Healthcare Provider Details

I. General information

NPI: 1730673682
Provider Name (Legal Business Name): KIM ALLISON MADRONA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 N BLACKSTONE ST
TULARE CA
93274-4449
US

IV. Provider business mailing address

3343 PARKS AVE
TULARE CA
93274-7466
US

V. Phone/Fax

Practice location:
  • Phone: 559-688-2021
  • Fax: 559-687-7317
Mailing address:
  • Phone: 559-827-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number240089940
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: