DR. NICOLE WAGENBERG (NPI# 1043768237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043768237 |
| Entity Type | Individual |
| Full Name | DR. NICOLE WAGENBERG |
| Other Name | DR. NICOLA WAGENBERG |
| Credential | PHD |
| Practice Address |
925 The Alameda Berkeley CA 94707-2310 |
| Mailing Address |
1415 Bonita Ave Berkeley CA 94709-1908 |
| Practice Telephone | 5106982491 |
| Mailing Telephone | 4153051425 |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2020-02-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY27376 | CA | Behavioral Health & Social Service Providers |
| Street Address |
925 THE ALAMEDA |
| City | BERKELEY |
| State | CA |
| Zip Code | 94707-2310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548219033 | Peggy Orlin | Counselor | 925 The Alameda, Berkeley, CA 94707-2310 | 2006-05-10 |
| 1326505165 | Dominique Lambert-blum | Counselor | 925 The Alameda, Berkeley, CA 94707-2310 | 2019-02-28 |
| 1346647187 | Sandra Seidlitz | Counselor | 925 The Alameda, Berkeley, CA 94707-2310 | 2014-11-21 |
| 1467856948 | Kathleen Engelberg | Marriage & Family Therapist | 925 The Alameda, Berkeley, CA 94707-2310 | 2014-10-13 |
| 1780817296 | Gina Murrell | Psychologist | 925 The Alameda, Ste 14, Berkeley, CA 94707-2310 | 2009-08-31 |
| 1043450612 | Melissa Currie Anderson | Marriage & Family Therapist | 925 The Alameda, Suite 15, Berkeley, CA 94707-2310 | 2009-02-23 |
| 1972643047 | Christa Stalberg Donaldson | Psychologist | 925 The Alameda, Berkeley, CA 94707-2310 | 2007-02-07 |
| 1598811051 | Mitchell John Houston | Psychologist | 925 The Alameda, Berkeley, CA 94707-2310 | 2007-01-26 |
| 1477607646 | David Arthur Vandevert | Marriage & Family Therapist | 925 The Alameda, Suite 24, Berkeley, CA 94707-2310 | 2007-01-23 |
| 1871641282 | Richard Kenneth Bloom | Psychologist | 925 The Alameda, #11, Berkeley, CA 94707 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306389556 | Tuyet-lyn Christensen | Marriage & Family Therapist | 925 The Alameda, Suite 23, Berkeley, CA 94707 | 2016-11-21 |
| 1457807208 | William L Carpenter | Registered Nurse | 875 Arlington Ave, Berkeley, CA 94707 | 2016-08-31 |
| 1992136451 | Zeph Locke | Marriage & Family Therapist | 1760 Solano Ave 300, Berkeley, CA 94707 | 2013-12-10 |
| 1295033553 | Emily Zubritsky | Counselor | 725 Spruce St., Berkeley, CA 94707 | 2011-03-09 |
| 1093025728 | Hajera Rostam | Psychologist | 970 Tulare Avenue, Berkeley, CA 94707 | 2010-10-15 |
| 1457689382 | Rand Steven Pallock | Marriage & Family Therapist | 1635 Soland Ave, Berkeley, CA 94707 | 2009-12-04 |
| 1598936957 | Doreen Ruth Downing | Psychologist | 1700 Solano Ave. Suite F, Berkeley, CA 94707 | 2008-03-13 |
| 1861688285 | Thomas James Hendrickson | Chiropractor | 388 Colusa Circle, Kensington, CA 94707 | 2007-09-19 |
| 1184827362 | Barbara Louise Mercer | Psychologist | 376 Colusa Avenue, Suite 1, Kensington, CA 94707 | 2007-06-06 |
| 1679780480 | Judithann H. David | Psychologist | 919 The Alameda Ste 5, 919 The Alameda Ste 5, Berkeley, CA 94707 | 2007-05-17 |
| Find all providers in zip 94707 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184241754 | Bede John Healey | Psychologist | 1371 La Loma Ave, Berkeley, CA 94708-2031 | 2020-06-30 |
| 1124683388 | Jason Craig Zeltser | Psychologist | 1708 Shattuck Ave Ste 9, Berkeley, CA 94709-1700 | 2019-05-03 |
| 1871157016 | Mary L Roche | Psychologist | 2955 Shattuck Ave Ste 3, Berkeley, CA 94705-1808 | 2019-04-23 |
| 1508320128 | Lauren Tolk | Psychologist | 1172 San Pablo Ave Ste 100, Berkeley, CA 94706-2258 | 2019-01-28 |
| 1336632876 | Jonathan Knight Howard | Psychologist | 2407 Dana St, Berkeley, CA 94704-2207 | 2018-06-09 |
| 1457866550 | Noah Bach Bar-tura | Psychologist | 2140 Shattuck Ave Ste 508, Berkeley, CA 94704-1222 | 2017-12-11 |
| 1750825154 | Stacy Taniguchi | Psychologist | 2000 Hearst Ave Ste 207, Berkeley, CA 94709 | 2016-12-05 |
| 1881048775 | Phillip Montes | Psychologist | 2014 Channing Way Apt 3, Berkeley, CA 94704-1935 | 2016-04-18 |
| 1790199446 | Irene Chui | Psychologist | 1197 Sutter St, Berkeley, CA 94707-2637 | 2014-06-19 |
| 1629322763 | Roxanne Manning | Psychologist | 1325 Sacramento St, Apt 3, Berkeley, CA 94702-1235 | 2012-10-26 |
| Find all providers in BERKELEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.