MEDICARE: VANESSA MAGANA

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
1	1041C0700X	Clinical Social Worker	106597	TX
2	1041C0700X	Clinical Social Worker	28116-C	AR

General Provider Information

NPI Number	:	1447110812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MAGANA

Provider Business Mailing Address
First Line	:	5750 E UNIVERSITY BLVD APT 532
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5750 E UNIVERSITY BLVD APT 532
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206
Country	:	US
Telephone Number	:	479-283-5568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	12/02/2025

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Directions to “ VANESSA MAGANA ” Practice Location

Language	Start Address	Practice Location

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