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MRS. DRETONA TENESE MADDOX RN PHN LCSW NPI 1417083643


NPI Information

NPI: 1417083643
Provider Name: MRS. DRETONA TENESE MADDOX, RN, PHN, LCSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

Address:
1410 3RD ST
SUITE 2
RIVERSIDE, CA
ZIP 92507
Phone: (909) 471-0697
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MRS. Dretona Tenese Maddox, RN, PHN, LCSW is a clinical social worker in Riverside, CA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MRS. Dretona Tenese Maddox, RN, PHN, LCSW NPI is 1417083643. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1410 3RD ST
SUITE 2
RIVERSIDE, CA
ZIP 92507-482
Phone: (909) 471-0697
Fax: (760) 302-7607

The enumeration date for this NPI number is 2/23/2007 and was last updated on 8/8/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163W00000XRegistered Nurse618042CALIFORNIANo
2163WC0400XRegistered NurseCase Management618042CALIFORNIANo
3163WC1500XRegistered NurseCommunity Health618042CALIFORNIANo
4163WC1600XRegistered NurseContinuing Education/Staff Development618042CALIFORNIANo
5163WM0102XRegistered NurseMaternal Newborn618042CALIFORNIANo
6163WN0002XRegistered NurseNeonatal Intensive Care618042CALIFORNIANo
7163WN0003XRegistered NurseNeonatal, Low-Risk618042CALIFORNIANo
8163WN1003XRegistered NurseNutrition Support618042CALIFORNIANo
9163WP0200XRegistered NursePediatrics618042CALIFORNIANo
10163WP0807XRegistered NursePsychiatric/Mental Health, Child & Adolescent618042CALIFORNIANo
111041C0700XSocial WorkerClinical81337CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1RVN004760MEDICAIDCALIFORNIA
2EPS016610MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.