Provider Demographics
NPI:1417720095
Name:MADDALONE, ANTOINETTE TERESA
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:TERESA
Last Name:MADDALONE
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 1:701 POPE DR APT A
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-6749
Mailing Address - Country:US
Mailing Address - Phone:707-515-8223
Mailing Address - Fax:
Practice Address - Street 1:701 POPE DR APT A
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-6749
Practice Address - Country:US
Practice Address - Phone:707-515-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula