Provider Demographics
NPI:1376158758
Name:ALFORD, MADISON RAINE
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:RAINE
Last Name:ALFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6615 VALLEY HI DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-7076
Mailing Address - Country:US
Mailing Address - Phone:916-450-2650
Mailing Address - Fax:
Practice Address - Street 1:9837 FOLSOM BLVD STE F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1356
Practice Address - Country:US
Practice Address - Phone:916-450-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2022-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator