Provider Demographics
NPI:1982909834
Name:TODD, MAGEN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAGEN
Middle Name:M
Last Name:TODD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 BENTWATER LOOP
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-7749
Mailing Address - Country:US
Mailing Address - Phone:626-497-3433
Mailing Address - Fax:
Practice Address - Street 1:95 DECLARATION DR STE 2
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-4916
Practice Address - Country:US
Practice Address - Phone:626-497-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23665103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical