Provider Demographics
NPI:1164803664
Name:MAGANA, JOSHUA TAU
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:TAU
Last Name:MAGANA
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 1:3106 S LINDA WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6130
Mailing Address - Country:US
Mailing Address - Phone:714-616-0935
Mailing Address - Fax:
Practice Address - Street 1:3106 S LINDA WAY
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6130
Practice Address - Country:US
Practice Address - Phone:714-616-0935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN255220164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse