Provider Demographics
NPI:1477200020
Name:CONTRERAS MAGANA, MARIA CRISTAL (MD, ASW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CRISTAL
Last Name:CONTRERAS MAGANA
Suffix:
Gender:F
Credentials:MD, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 SHAW AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3819
Mailing Address - Country:US
Mailing Address - Phone:559-825-1324
Mailing Address - Fax:
Practice Address - Street 1:55 SHAW AVE STE 115
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3819
Practice Address - Country:US
Practice Address - Phone:559-825-1324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1030041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical