Provider Demographics
NPI:1295915734
Name:MAGNUSSON, ALICE ELIZABETH (MA)
Entity type:Individual
Prefix:MISS
First Name:ALICE
Middle Name:ELIZABETH
Last Name:MAGNUSSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:ELIZABETH
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:5777 MADISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-3659
Mailing Address - Country:US
Mailing Address - Phone:916-494-1471
Mailing Address - Fax:
Practice Address - Street 1:5777 MADISON AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3315
Practice Address - Country:US
Practice Address - Phone:916-494-1471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist