Richard Piedra Madero, LCSW

Individual provider Active NPI Clinical Social Worker · Blue Jay, CA

NPI 1437584547 · NPPES record last updated May 10, 2024

Key facts

NPI
1437584547
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
106291 (CA)
Practice address
PO Box 1401
Blue Jay, CA 92317-1401
Phone
(818) 378-0594
NPI assigned
Sep 9, 2013
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
106291CAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 106291 CA Yes

Addresses

Primary practice location

PO Box 1401
Blue Jay, CA 92317-1401

Mailing address

PO Box 1401
Blue Jay, CA 92317-1401
Phone (818) 378-0594

Other providers in Blue Jay, CA

All providers in Blue Jay, CA · Clinical Social Worker in California

Sources for this page

Verify at the official NPI Registry.