Provider Demographics
NPI:1194750364
Name:MCDONALD, MARGARET CALLAS (PHD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:CALLAS
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:CALLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:6480 DANIKA CT
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3668
Mailing Address - Country:US
Mailing Address - Phone:530-872-2444
Mailing Address - Fax:530-877-0640
Practice Address - Street 1:1660 HUMBOLDT RD
Practice Address - Street 2:STE. 3
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9199
Practice Address - Country:US
Practice Address - Phone:530-345-2966
Practice Address - Fax:530-877-0640
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY5962103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
R26330Medicare UPIN