Provider Demographics
NPI:1366322521
Name:MADRIGAL, CHEYENNE (MS, CC-SLP)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:MS, CC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:261 CANYON BREEZE CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-8216
Mailing Address - Country:US
Mailing Address - Phone:805-427-4200
Mailing Address - Fax:
Practice Address - Street 1:261 CANYON BREEZE CT
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-8216
Practice Address - Country:US
Practice Address - Phone:805-427-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist