Madrigal, Jesus A
Madrigal, Jesus A is an individual health care provider with primary practice located at 360 Whiskey Hill Rd , La Selva Beach CA 95076-8521. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Madrigal, Jesus A can be contacted via phone (831) 724-9333.Contact Information
Primary practice address
360 Whiskey Hill Rd
La Selva Beach CA 95076-8521
Phone: (831) 724-9333
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1407072101 |
|---|---|
| LBN Legal business name | Madrigal, Jesus A |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 18th, 2007 |
| Last updated | Jul 21st, 2011 - about 13 years ago |
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 | 1407072101 | NPPES |
| Other | ZZZ91892Z | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# |
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