Provider Demographics
NPI:1003299025
Name:MAGAZZU-ALAMAN, MICAELA (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MICAELA
Middle Name:
Last Name:MAGAZZU-ALAMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:MS
Other - First Name:MICAELA
Other - Middle Name:
Other - Last Name:MAGAZZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:325 W WASHINGTON STREET
Mailing Address - Street 2:SUITE 2 #3010
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1946
Mailing Address - Country:US
Mailing Address - Phone:619-839-9397
Mailing Address - Fax:
Practice Address - Street 1:2385 SAN DIEGO AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2835
Practice Address - Country:US
Practice Address - Phone:619-839-9397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120272106H00000X
CA95925106H00000X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program