Provider Demographics
NPI:1568831790
Name:MAGADIA, MARIANFLOR ESCARTIN (LVN)
Entity Type:Individual
Prefix:
First Name:MARIANFLOR
Middle Name:ESCARTIN
Last Name:MAGADIA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4137 ELKHORN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH HIGHLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:95660-3502
Mailing Address - Country:US
Mailing Address - Phone:916-607-8879
Mailing Address - Fax:
Practice Address - Street 1:7171 BOWLING DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2034
Practice Address - Country:US
Practice Address - Phone:916-875-0703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270084164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse