Provider Demographics
NPI:1669778064
Name:MIMIAGA, MARGARET G (MFT)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:G
Last Name:MIMIAGA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16704 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5204
Mailing Address - Country:US
Mailing Address - Phone:562-867-1737
Mailing Address - Fax:562-867-6717
Practice Address - Street 1:16704 CLARK AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5204
Practice Address - Country:US
Practice Address - Phone:562-867-1737
Practice Address - Fax:562-867-6717
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-01
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC49222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health