Provider Demographics
NPI:1396344081
Name:MAGALLANES, VENTANA L
Entity type:Individual
Prefix:
First Name:VENTANA
Middle Name:L
Last Name:MAGALLANES
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 1:368 FELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-5144
Mailing Address - Country:US
Mailing Address - Phone:415-861-0828
Mailing Address - Fax:415-861-0140
Practice Address - Street 1:52 SHRADER ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1015
Practice Address - Country:US
Practice Address - Phone:415-240-6913
Practice Address - Fax:415-861-0140
Is Sole Proprietor?:No
Enumeration Date:2020-10-22
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist