Provider Demographics
NPI:1639247901
Name:MAGDALENA, FAITH GRACE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:FAITH
Middle Name:GRACE
Last Name:MAGDALENA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2033
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93120-2033
Mailing Address - Country:US
Mailing Address - Phone:805-899-1153
Mailing Address - Fax:
Practice Address - Street 1:206 W ANAPAMU ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3605
Practice Address - Country:US
Practice Address - Phone:805-899-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC26060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist