Healthcare Provider Details

I. General information

NPI: 1437778081
Provider Name (Legal Business Name): MATTHEW GABRIEL MAGANA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2020
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

982 MISSION ST FL 2
SAN FRANCISCO CA
94103-2911
US

IV. Provider business mailing address

1263 MISSION ST
SAN FRANCISCO CA
94103-2705
US

V. Phone/Fax

Practice location:
  • Phone: 415-597-8000
  • Fax: 415-597-8004
Mailing address:
  • Phone: 626-222-9782
  • Fax: 415-514-6466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: