Provider Demographics
NPI:1851176119
Name:TADEO, MARIA ESTHER
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ESTHER
Last Name:TADEO
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 1:14375 IVY AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3059
Mailing Address - Country:US
Mailing Address - Phone:909-827-6210
Mailing Address - Fax:
Practice Address - Street 1:316 E E ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-3712
Practice Address - Country:US
Practice Address - Phone:909-983-4466
Practice Address - Fax:909-983-1166
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator