Provider Demographics
NPI:1699006619
Name:MAGANA, NORA
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:MAGANA
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:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95106-0668
Mailing Address - Country:US
Mailing Address - Phone:408-483-9672
Mailing Address - Fax:
Practice Address - Street 1:1190 LINCOLN AVE
Practice Address - Street 2:7
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-3036
Practice Address - Country:US
Practice Address - Phone:408-483-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPPC #249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional