Provider Demographics
NPI:1386398287
Name:MAGANA, SIERRA REVE
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:REVE
Last Name:MAGANA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 FILLMORE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:FILLMORE
Mailing Address - State:CA
Mailing Address - Zip Code:93015-2062
Mailing Address - Country:US
Mailing Address - Phone:805-727-6109
Mailing Address - Fax:
Practice Address - Street 1:811 W TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-5400
Practice Address - Country:US
Practice Address - Phone:805-850-8436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician