Provider Demographics
NPI:1841394061
Name:MAGID, BILLIE JEAN (MFCC)
Entity Type:Individual
Prefix:MRS
First Name:BILLIE
Middle Name:JEAN
Last Name:MAGID
Suffix:
Gender:F
Credentials:MFCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 COUNTY CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403
Mailing Address - Country:US
Mailing Address - Phone:707-524-8812
Mailing Address - Fax:415-883-9169
Practice Address - Street 1:2400 COUNTY CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-524-8812
Practice Address - Fax:415-883-9169
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC30892103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist