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General NPI Number Information
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NPI Number | 1427178367
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Entity Type | Individual
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Provider Name | MAGGIE TAM HAGA
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Gender | Female
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Dates
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Enumeration Date | 03/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7872 WALKER ST SUITE 200
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City | LA PALMA
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State | CA
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Zip | 90623-1796
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Country | US
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Telephone | 626-893-8632
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Fax |
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Provider Business Mailing Address
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Address Line | 19314 ALCONA ST
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-3907
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Country | US
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Telephone | 626-893-8632
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS17474
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License Number State | CA
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