Provider Demographics
NPI:1386120392
Name:MADRIGAL, ALVA MARINA (LCSW)
Entity type:Individual
Prefix:
First Name:ALVA
Middle Name:MARINA
Last Name:MADRIGAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 N AUGUSTA ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701-2387
Mailing Address - Country:US
Mailing Address - Phone:559-457-3420
Mailing Address - Fax:
Practice Address - Street 1:2309 TULARE ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-2266
Practice Address - Country:US
Practice Address - Phone:559-457-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
CA1167311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical