Provider Demographics
NPI:1659195899
Name:ALMA FIRST FELLOWS
Entity type:Organization
Organization Name:ALMA FIRST FELLOWS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:YIMDRIUSKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:707-694-9057
Mailing Address - Street 1:45 PEARCE ST
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-4018
Mailing Address - Country:US
Mailing Address - Phone:707-694-9057
Mailing Address - Fax:
Practice Address - Street 1:45 PEARCE ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-4018
Practice Address - Country:US
Practice Address - Phone:707-694-9057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-14
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health