Provider Demographics
NPI:1285289546
Name:SNIEGOSKI MAGBAG, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SNIEGOSKI MAGBAG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 436
Mailing Address - Street 2:
Mailing Address - City:MOUNT HERMON
Mailing Address - State:CA
Mailing Address - Zip Code:95041-0436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 436
Practice Address - Street 2:
Practice Address - City:MOUNT HERMON
Practice Address - State:CA
Practice Address - Zip Code:95041-0436
Practice Address - Country:US
Practice Address - Phone:714-955-3789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician