Provider Demographics
NPI:1861416984
Name:MAGANA, DOLORES P (NP)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:P
Last Name:MAGANA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1615 BUNKER HILL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-6013
Mailing Address - Country:US
Mailing Address - Phone:831-769-1304
Mailing Address - Fax:831-757-0291
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 200, SUITE 105
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-769-8660
Practice Address - Fax:831-769-8655
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA16025363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB6945190OtherDRIVER LICENSE
CA592182OtherRN LICENSE