Provider Demographics
NPI:1134494677
Name:MAGARETT, JONATHAN ALLISON
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ALLISON
Last Name:MAGARETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2936 EDNA ST
Mailing Address - Street 2:
Mailing Address - City:LAKE ISABELLA
Mailing Address - State:CA
Mailing Address - Zip Code:93240-9221
Mailing Address - Country:US
Mailing Address - Phone:760-417-9747
Mailing Address - Fax:
Practice Address - Street 1:2731 NUGGET AVE
Practice Address - Street 2:
Practice Address - City:LAKE ISABELLA
Practice Address - State:CA
Practice Address - Zip Code:93240
Practice Address - Country:US
Practice Address - Phone:760-379-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor