Healthcare Provider Details

I. General information

NPI: 1083394969
Provider Name (Legal Business Name): MARIAH MAGANA AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 FLORIN RD
SACRAMENTO CA
95822-4332
US

IV. Provider business mailing address

2123 FLORIN RD
SACRAMENTO CA
95822-4332
US

V. Phone/Fax

Practice location:
  • Phone: 916-360-0283
  • Fax:
Mailing address:
  • Phone: 925-980-2171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number163168
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: