Provider Demographics
NPI:1871937888
Name:MAGNUSON, CINDY KAY (PT)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:KAY
Last Name:MAGNUSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 TEMPLETON DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-3765
Mailing Address - Country:US
Mailing Address - Phone:530-226-1921
Mailing Address - Fax:530-226-1921
Practice Address - Street 1:2490 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2540
Practice Address - Country:US
Practice Address - Phone:530-246-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15280314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility