Provider Demographics
NPI:1285733840
Name:IGARTA, MAGDELINE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MAGDELINE
Middle Name:
Last Name:IGARTA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12286 BAJA PANORAMA
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-1304
Mailing Address - Country:US
Mailing Address - Phone:714-318-8110
Mailing Address - Fax:
Practice Address - Street 1:3030 N HESPERIAN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-1151
Practice Address - Country:US
Practice Address - Phone:714-836-2739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS211151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical