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Individual
MRS. DRETONA TENESE MADDOX
Active
Individual
MRS. DRETONA TENESE MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN, LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
81337
CA
163W00000X
Registered Nurse
618042
CA
163WC0400X
Case Management Registered Nurse
618042
CA
163WC1500X
Community Health Registered Nurse
618042
CA
163WC1600X
Continuing Education/Staff Development Registered Nurse
618042
CA
163WM0102X
Maternal Newborn Registered Nurse
618042
CA
163WN0002X
Neonatal Intensive Care Registered Nurse
618042
CA
163WN0003X
Low-Risk Neonatal Registered Nurse
618042
CA
163WN1003X
Nutrition Support Registered Nurse
618042
CA
163WP0200X
Pediatric Registered Nurse
618042
CA
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
618042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EPS016610
—
CA
05
—
RVN004760
—
CA
Enumeration date
02/23/2007
Last updated
08/08/2023
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