Provider Demographics
NPI:1982138491
Name:MADRIGAL, SONIA (FNP)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10242 E AVENUE R4
Mailing Address - Street 2:
Mailing Address - City:LITTLEROCK
Mailing Address - State:CA
Mailing Address - Zip Code:93543-1310
Mailing Address - Country:US
Mailing Address - Phone:661-733-2958
Mailing Address - Fax:
Practice Address - Street 1:10242 EAST AVE R-4
Practice Address - Street 2:
Practice Address - City:LITTLEROCK
Practice Address - State:CA
Practice Address - Zip Code:93543
Practice Address - Country:US
Practice Address - Phone:661-733-2958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006463363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner