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Individual
ELLIANA IXTA MADERA
Active
Individual
ELLIANA IXTA MADERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
63242
CA
104100000X
Social Worker
63242
CA
1041C0700X
Clinical Social Worker
Primary
103120
CA
225400000X
Rehabilitation Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2013
Last updated
08/19/2021
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