Provider Demographics
NPI:1932676509
Name:MADRIGAL, ANA LETICIA (RCP)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LETICIA
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:LETICIA
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1515 N VERMONT AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5337
Mailing Address - Country:US
Mailing Address - Phone:323-783-8042
Mailing Address - Fax:323-783-3081
Practice Address - Street 1:1515 N VERMONT AVE STE 111
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5337
Practice Address - Country:US
Practice Address - Phone:323-783-8042
Practice Address - Fax:323-783-3081
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14686227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified