Marlo Maddox-Kleckley, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A80427 Issued in CA

Practice address

2230 Stockton Blvd RM 202
Sacramento, CA 95817-1353

Phone

(916) 734-7523

Fax

(916) 734-3384

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mmaddoxkleckley653931@direct.ochin.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1275557175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 STOCKTON BLVD RM 202",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171353",
            "telephone_number": "916-734-7523",
            "fax_number": "916-734-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 STOCKTON BLVD RM 202",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171353",
            "telephone_number": "916-734-7523",
            "fax_number": "916-734-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDOX-KLECKLEY",
        "first_name": "MARLO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80427",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A80427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Kennedy Madden, PHD, RN, ACNP
• Ross Patrick Madden, PA-C
• Sadey Ashley Madden
• Garret S. Madderra, DDS
• Richard J Maddock, M.D.
• Justin Maddux, DC
• Kathleen Helen Madeira, RN
• Madeleine Shernock Corp.
• Erich P Madero-Schmidt, PA
• Cheyenne Madero

• Psychiatry Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.