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General NPI Number Information
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NPI Number | 1922323922
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Entity Type | Individual
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Provider Name | SOPHIA LIN MAGANA OTD, OTR/L, SWC
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Gender | Female
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Dates
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Enumeration Date | 04/01/2010
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 321 MIDDLEFIELD RD STE 130
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City | MENLO PARK
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State | CA
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Zip | 94025-4010
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Country | US
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Telephone | 506-460-9278
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Fax |
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Provider Business Mailing Address
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Address Line | 321 MIDDLEFIELD RD STE 130
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City | MENLO PARK
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State | CA
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Zip | 94025-4010
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Country | US
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Telephone | 650-460-9278
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT9579
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License Number State | CA
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