Healthcare Provider Details

I. General information

NPI: 1508551227
Provider Name (Legal Business Name): MADISON MARIE HUIRACHE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2513 YOUNGSTOWN RD
TURLOCK CA
95380-9707
US

IV. Provider business mailing address

2365 LINDEN ST
ATWATER CA
95301-2850
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-8482
  • Fax:
Mailing address:
  • Phone: 209-427-5862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: