Provider Demographics
NPI:1467575712
Name:MADERA, ORALIA (RN, CDE)
Entity Type:Individual
Prefix:
First Name:ORALIA
Middle Name:
Last Name:MADERA
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 BATH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4321
Mailing Address - Country:US
Mailing Address - Phone:805-682-7640
Mailing Address - Fax:805-682-3332
Practice Address - Street 1:2219 BATH ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4321
Practice Address - Country:US
Practice Address - Phone:805-682-7640
Practice Address - Fax:805-682-3332
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA217098171W00000X, 163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No171W00000XOther Service ProvidersContractor