Provider Demographics
NPI:1811383557
Name:WATERFALL-QUITON, MADELEINE SIRIKIT (RN, BSN)
Entity Type:Individual
Prefix:MRS
First Name:MADELEINE
Middle Name:SIRIKIT
Last Name:WATERFALL-QUITON
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:901 BLANCO CIR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4401
Mailing Address - Country:US
Mailing Address - Phone:831-529-4789
Mailing Address - Fax:831-769-0732
Practice Address - Street 1:3715 COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-2719
Practice Address - Country:US
Practice Address - Phone:661-868-7159
Practice Address - Fax:661-868-7172
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA802681163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse