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General NPI Number Information
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NPI Number | 1700268463
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Entity Type | Individual
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Provider Name | DAVID PATRICK MADDALENA LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 09/09/2018
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Provider Practice Location Address
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Address Line | 1307 S MARY AVE STE 205
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City | SUNNYVALE
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State | CA
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Zip | 94087
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Country | US
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Telephone | 650-648-3623
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Fax |
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Provider Business Mailing Address
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Address Line | 1473 MIRAMONTE AVE UNIT 3
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City | LOS ALTOS
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State | CA
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Zip | 94024-5605
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Country | US
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Telephone | 650-648-3623
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | CA
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