Healthcare Provider Details

I. General information

NPI: 1720752157
Provider Name (Legal Business Name): CRISTAL MAGANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 OLDS RD
OXNARD CA
93033-8051
US

IV. Provider business mailing address

4200 OLDS RD
OXNARD CA
93033-8060
US

V. Phone/Fax

Practice location:
  • Phone: 805-488-4441
  • Fax:
Mailing address:
  • Phone: 805-488-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number260231269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: