Provider Demographics
NPI:1124136635
Name:MAGEE, JANNA EMMONS (PHD)
Entity type:Individual
Prefix:DR
First Name:JANNA
Middle Name:EMMONS
Last Name:MAGEE
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 1:600 SUNLAND PARK DR
Mailing Address - Street 2:BLDG. 1-300
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5115
Mailing Address - Country:US
Mailing Address - Phone:915-845-2260
Mailing Address - Fax:915-585-2016
Practice Address - Street 1:600 SUNLAND PARK DR
Practice Address - Street 2:BLDG. 1-300
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5115
Practice Address - Country:US
Practice Address - Phone:915-845-2260
Practice Address - Fax:915-585-2016
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21425103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN81468POtherBC/BS
TN81468POtherBC/BS
TXR57298Medicare UPIN