Individual
JOHNNICO ANDREW MAGANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 N 9TH ST STE C, MODESTO, CA 95350-5814
(209) 558-4420
Mailing address
500 N 9TH ST STE C, MODESTO, CA 95350-5814
(209) 558-4420
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
01/22/2025
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