DR. DESTINY M WAGGONER (NPI# 1235582727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235582727 |
| Entity Type | Individual |
| Full Name | DR. DESTINY M WAGGONER |
| Credential | PH.D. |
| Practice Address |
306 San Pablo St Se Albuquerque NM 87108 |
| Mailing Address |
306 San Pablo St Se Albuquerque NM 87108-3167 |
| Practice Telephone | 5052720415 |
| Mailing Telephone | 5052720415 |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2019-10-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PSY1566 | NM | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3401 Eudora St, Child & Family Outpatient Services, Denver, CO 80207 | 3033006163 |
| Street Address |
306 SAN PABLO ST SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942270129 | John R Buchan | Social Worker | 306 San Pablo St Se, Albuquerque, NM 87108-3167 | 2006-01-23 |
| 1629600366 | Marlene Rocio Espinoza Barboza | Counselor | 306 San Pablo St Se, Albuquerque, NM 87108-3167 | 2020-02-11 |
| 1144877374 | Edith Moon | Nurse Practitioner | 306 San Pablo St Se, Albuquerque, NM 87108-3167 | 2019-08-22 |
| 1124392881 | Paula Marechal | Social Worker | 306 San Pablo St Se, Albuquerque, NM 87108-3167 | 2012-02-28 |
| 1962738708 | Tanya Michelle Ramos | Psychologist | 306 San Pablo St Se, Suite A, Albuquerque, NM 87108-3167 | 2009-10-29 |
| 1982837324 | Jenny Elizabeth Mull | Social Worker | 306 San Pablo St Se, Albuquerque, NM 87108-3167 | 2009-09-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144844747 | Ellen Soisson | Psychologist | 11005 Spain Rd Ne Ste 8, Albuquerque, NM 87111-1871 | 2020-05-31 |
| 1124584313 | Mark Simpson Psyd Mac Ladc LLC | Psychologist | 2920 Carlisle Blvd Ne Ste G, Albuquerque, NM 87110-2867 | 2019-02-13 |
| 1548775414 | Julie Brovko | Psychologist | 215 Gold Ave Sw Ste 202, Albuquerque, NM 87102-3364 | 2017-12-13 |
| 1134633498 | Evan Espinosa | Psychologist | 933 Bradbury Dr. Se, Suite 2222, Albuquerque, NM 87106-4374 | 2017-11-24 |
| 1982113205 | Diana Bennett | Psychologist | 1501 San Pedro Dr Se # Mc116, Albuquerque, NM 87108-5153 | 2017-09-29 |
| 1518411297 | Emily Kathryn Andrews | Psychologist | 1001 Yale Boulevard Ne, Albuquerque, NM 87131-1830 | 2016-08-10 |
| 1982076402 | Sally Eden Moretti | Psychologist | 5920 Canyon Vista Dr Ne, Albuquerque, NM 87111-6621 | 2015-10-23 |
| 1881087526 | Aaron Joyce, Ph.d., LLC | Psychologist | 3532 Anderson Ave. Se, Albuquerque, NM 87106 | 2015-03-05 |
| 1073903506 | Samardzija Psychological Center | Psychologist | 12900 Sandia Point Rd Ne, Albuquerque, NM 87111-8198 | 2015-02-04 |
| 1679974943 | Sage Behavioral Health Center | Psychologist | 2929 Coors Blvd Nw Ste 100d, Albuquerque, NM 87120-1272 | 2014-09-05 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
Please comment or provide details below to improve the information on DR. DESTINY M WAGGONER.
| 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.