Provider Demographics
NPI:1740909183
Name:MADRIGAL, DENISE (AMFT)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:
Last Name:MADRIGAL
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-1705
Mailing Address - Country:US
Mailing Address - Phone:415-206-7600
Mailing Address - Fax:
Practice Address - Street 1:1309 EVANS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1705
Practice Address - Country:US
Practice Address - Phone:415-206-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144814106H00000X
172V00000X
CAAMFT144814106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker