Maddox, Dretona Tenese
Maddox, Dretona Tenese is an individual health care provider with primary practice located at 1410 3Rd St Suite 2, Riverside CA 92507-3482. She recently has 11 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Case Management, Nursing Service Providers / Community Health, Nursing Service Providers / Continuing Education/Staff Development, Nursing Service Providers / Maternal Newborn, Nursing Service Providers / Neonatal Intensive Care, Nursing Service Providers / Neonatal, Low-Risk, Nursing Service Providers / Nutrition Support, Nursing Service Providers / Pediatrics, Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Maddox, Dretona Tenese can be contacted via phone (909) 471-0697.Contact Information
Primary practice address
1410 3Rd St Suite 2
Riverside CA 92507-3482
Phone: (909) 471-0697
Fax: (760) 302-7607
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Registered Nurse | 163W00000X | 618042 | California |
| Nursing Service Providers / Case Management | 163WC0400X | 618042 | California |
| Nursing Service Providers / Community Health | 163WC1500X | 618042 | California |
| Nursing Service Providers / Continuing Education/Staff Development | 163WC1600X | 618042 | California |
| Nursing Service Providers / Maternal Newborn | 163WM0102X | 618042 | California |
| Nursing Service Providers / Neonatal Intensive Care | 163WN0002X | 618042 | California |
| Nursing Service Providers / Neonatal, Low-Risk | 163WN0003X | 618042 | California |
| Nursing Service Providers / Nutrition Support | 163WN1003X | 618042 | California |
| Nursing Service Providers / Pediatrics | 163WP0200X | 618042 | California |
| Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent | 163WP0807X | 618042 | California |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 81337 | California |
Profile Details
| NPI number | 1417083643 |
|---|---|
| LBN Legal business name | Maddox, Dretona Tenese |
| Credentials | RN, PHN, LCSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 23rd, 2007 |
| Last updated | Aug 8th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417083643 | NPPES |
| California | MEDICAID | RVN004760 | |
| California | MEDICAID | EPS016610 |
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