Individual
DR. CARLA BACK-MADRUGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8055 W MANCHESTER AVE, SUITE 235, PLAYA DEL REY, CA 90293-7960
(319) 827-9851
Mailing address
8055 W MANCHESTER AVE, SUITE 235, PLAYA DEL REY, CA 90293-7960
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY14950
CA
Other
Enumeration date
10/04/2013
Last updated
10/04/2013
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