Provider Demographics
NPI:1477304012
Name:MADRIGAL, RYLEEN LOIS (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:RYLEEN LOIS
Middle Name:
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12936 SIERRA CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-8460
Mailing Address - Country:US
Mailing Address - Phone:714-768-8465
Mailing Address - Fax:
Practice Address - Street 1:12936 SIERRA CREEK DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-8460
Practice Address - Country:US
Practice Address - Phone:714-768-8465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA615642163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse