Provider Demographics
NPI:1649004029
Name:EGGER, ABIGAIL MARIE
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:MARIE
Last Name:EGGER
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 1:11465 MAGNOLIA AVE APT 687
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-6819
Mailing Address - Country:US
Mailing Address - Phone:951-332-1961
Mailing Address - Fax:
Practice Address - Street 1:765 N MAIN ST # 127
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92878-1440
Practice Address - Country:US
Practice Address - Phone:951-444-5820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1226101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical