Provider Demographics
NPI:1326198755
Name:MADRIGAL-SOLIS, ANTONIA CECILIA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:CECILIA
Last Name:MADRIGAL-SOLIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANTONIA
Other - Middle Name:CECILIA
Other - Last Name:MADRIGAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:21810 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2047
Mailing Address - Country:US
Mailing Address - Phone:310-783-4677
Mailing Address - Fax:310-783-4676
Practice Address - Street 1:21810 NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2047
Practice Address - Country:US
Practice Address - Phone:310-783-4677
Practice Address - Fax:310-783-4676
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22392103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical