Provider Demographics
NPI:1811152861
Name:MAGANA, ARTHUR ROBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:ROBERT
Last Name:MAGANA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:193 BLUE RAVINE ROAD
Mailing Address - Street 2:SUITE 170
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630
Mailing Address - Country:US
Mailing Address - Phone:916-608-0714
Mailing Address - Fax:916-608-0717
Practice Address - Street 1:193 BLUE RAVINE RD
Practice Address - Street 2:SUITE 170
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4758
Practice Address - Country:US
Practice Address - Phone:916-608-0714
Practice Address - Fax:916-608-0717
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18143103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist