Healthcare Provider Details

I. General information

NPI: 1457188708
Provider Name (Legal Business Name): EMMA MAE MAGIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 GEARY ST
SAN FRANCISCO CA
94109-7228
US

IV. Provider business mailing address

14 OCEAN GROVE AVE # 1A
DALY CITY CA
94015-3732
US

V. Phone/Fax

Practice location:
  • Phone: 628-216-0303
  • Fax:
Mailing address:
  • Phone: 916-899-4420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: