Provider Demographics
NPI:1023419686
Name:MAGAHIS, EUGENIA BRAZAL (NP)
Entity type:Individual
Prefix:
First Name:EUGENIA
Middle Name:BRAZAL
Last Name:MAGAHIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WILLOW PLZ
Mailing Address - Street 2:STE 305
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6215
Mailing Address - Country:US
Mailing Address - Phone:559-741-9034
Mailing Address - Fax:
Practice Address - Street 1:2100 POWELL ST
Practice Address - Street 2:SUITE 900
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1826
Practice Address - Country:US
Practice Address - Phone:510-350-2600
Practice Address - Fax:510-879-9084
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA608974363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner