Provider Demographics
NPI:1033381322
Name:MAGANA, SHANIDA ROXANA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHANIDA
Middle Name:ROXANA
Last Name:MAGANA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10365 OLD PLACERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2518
Mailing Address - Country:US
Mailing Address - Phone:916-214-1283
Mailing Address - Fax:
Practice Address - Street 1:10365 OLD PLACERVILLE RD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2518
Practice Address - Country:US
Practice Address - Phone:916-214-1283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX577451041C0700X
DCLC50078439104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical