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General NPI Number Information
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NPI Number | 1316875289
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Entity Type | Individual
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Provider Name | RICHARD MADES
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Gender | Male
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 2562 STATE ST
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City | CARLSBAD
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State | CA
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Zip | 92008-1663
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Country | US
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Telephone | 833-772-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 2874 CORTO ST
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City | OCEANSIDE
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State | CA
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Zip | 92054-4519
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Country | US
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Telephone | 540-903-0951
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | INTERN
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License Number State | CA
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