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General NPI Number Information
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NPI Number | 1891884334
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Entity Type | Individual
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Provider Name | TERESA MAGANA FNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 1503 E MARCH LN STE A
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City | STOCKTON
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State | CA
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Zip | 95210-5622
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Country | US
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Telephone | 209-462-7277
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Fax | 866-950-0134
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Provider Business Mailing Address
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Address Line | PO BOX 1434
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City | LODI
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State | CA
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Zip | 95241-1434
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Country | US
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Telephone | 209-462-7277
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Fax | 866-950-0134
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11924
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11924
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License Number State | CA
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