Healthcare Provider Details

I. General information

NPI: 1376200337
Provider Name (Legal Business Name): FRANCIS MAE MAGDADARO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2021
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 E LA PALMA AVE
ANAHEIM CA
92807-2075
US

IV. Provider business mailing address

5475 E LA PALMA AVE
ANAHEIM CA
92807-2075
US

V. Phone/Fax

Practice location:
  • Phone: 707-266-3795
  • Fax:
Mailing address:
  • Phone: 949-722-7118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95019232
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number95019232
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: