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NPI Code Detail

MEDICARE: MRS. JENNIFER MAGER B.A.

MEDICARE: MRS. JENNIFER MAGER B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1255467536
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER MAGER B.A.
Provider Business Mailing Address
First Line : 3960 WALNUT DR
Second Line :
City : EUREKA
State : CA
Zip : 95503-8938
Country : US
Telephone Number : 707-268-8722
Fax Number : 707-268-0218
Provider Business Practice Location Address
First Line : 3960 WALNUT DR
Second Line :
City : EUREKA
State : CA
Zip : 95503-8938
Country : US
Telephone Number : 707-268-8722
Fax Number : 707-268-0218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JENNIFER MAGER B.A.” Practice Location

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