Magdalena Martinez Bauman, LMFT

Individual provider Active NPI Marriage & Family Therapist · Sonora, CA

NPI 1295033504 · NPPES record last updated Jun 21, 2019

Key facts

NPI
1295033504
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
95512 (CA)
Practice address
175 Fairview LN.
Sonora, CA 95370
Phone
(209) 536-2092
NPI assigned
Mar 10, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
95512CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 66377 CA
Marriage & Family Therapist 106H00000X 95512 CA Yes

Addresses

Primary practice location

175 Fairview LN.
Sonora, CA 95370

Mailing address

175 Fairview LN.
Sonora, CA 95370
Phone (209) 536-2092

Other providers in Sonora, CA

All providers in Sonora, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.