Individual
MADISON DIRKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40925 COUNTY CENTER DR STE 110, TEMECULA, CA 92591-6037
(951) 940-6233
Mailing address
45356 VIA JACA, TEMECULA, CA 92592
(720) 505-9682
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
CA
175T00000X
Peer Specialist
Primary
MPSS-BHKNWJ
CA
Other
Enumeration date
03/22/2022
Last updated
04/17/2023
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