Provider Demographics
NPI:1487750071
Name:MAGEE, SANDRA GAIL (RDHAP)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:GAIL
Last Name:MAGEE
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 STOCKDALE HWY M-10 #203
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-1091
Mailing Address - Country:US
Mailing Address - Phone:661-631-1118
Mailing Address - Fax:661-631-1116
Practice Address - Street 1:8806 ROCKHAMPTON DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-4252
Practice Address - Country:US
Practice Address - Phone:661-631-1118
Practice Address - Fax:661-631-1116
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA147055OtherDELTA DENTAL
CAH00045-01Medicaid
CAY00045Medicaid
CAZ98419-2OtherHEALTHY FAMILIES