Provider Demographics
NPI:1629702097
Name:MAGOFFIN, JILL
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:MAGOFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 DRAKE DR
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-4216
Mailing Address - Country:US
Mailing Address - Phone:805-328-1911
Mailing Address - Fax:
Practice Address - Street 1:1290 DRAKE DR
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-4216
Practice Address - Country:US
Practice Address - Phone:805-328-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula