Eloise Madriaga, CADC1, MPSS

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Escondido, CA

NPI 1992376131 · NPPES record last updated Mar 15, 2024

Key facts

NPI
1992376131
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CI38700623 (CA)
Practice address
161 N Date St
Escondido, CA 92025-3405
Phone
(760) 745-7786
NPI assigned
Jul 8, 2021
Sex
Female
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
CI38700623CAMDAddiction (Substance Use Disorder) Counselor
MPSS-QTDFEWCAMDPeer Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Peer Specialist 175T00000X MPSS-QTDFEW CA
Addiction (Substance Use Disorder) Counselor 101YA0400X CI38700623 CA Yes

Addresses

Primary practice location

161 N Date St
Escondido, CA 92025-3405

Mailing address

161 N Date St
Escondido, CA 92025-3405
Phone (760) 745-7786

Other providers in Escondido, CA

All providers in Escondido, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.