PERRY WAGNER (NPI# 1700179520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700179520 |
| Entity Type | Individual |
| Full Name | PERRY WAGNER |
| Credential | RASI |
| Practice Address |
100 E Market St Long Beach CA 90805-5924 |
| Mailing Address |
2075 E Broadway Apt 206 Long Beach CA 90803-6231 |
| Practice Telephone | 5624284222 |
| Mailing Telephone | 9092446918 |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-05-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
100 E MARKET ST |
| City | LONG BEACH |
| State | CA |
| Zip Code | 90805-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750428496 | Felicitacion Sibayan Morris | Pediatrics | 100 E Market St, Long Beach, CA 90805-5924 | 2007-01-31 |
| 1740832088 | Cindy Urrutia | Licensed Vocational Nurse | 100 E Market St, Long Beach, CA 90805-5924 | 2019-07-16 |
| 1336791268 | Sharon Adams | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2019-07-11 |
| 1144702218 | Sidney Walker | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2018-09-05 |
| 1609322759 | Gabriel Cortes | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2016-08-29 |
| 1568917466 | West County Medical | Substance Abuse Rehabilitation Facility | 100 E Market St, Long Beach, CA 90805-5924 | 2016-08-20 |
| 1750636643 | John David Derosa | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2012-07-17 |
| 1942565700 | Cynthia Pizarro | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2012-07-09 |
| 1154681245 | Eldorado Community Service Center | Clinic/Center | 100 E Market St, Long Beach, CA 90805-5924 | 2012-05-22 |
| 1801181987 | Rodolfo Rubio | Counselor | 100 E Market St, Long Beach, CA 90805-5924 | 2011-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073154928 | Makando Mutanda | Counselor | 161 West Victoria St., Long Beach, CA 90805 | 2019-10-02 |
| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1609345925 | Belmont Rx LLC | Pharmacy | 6583 Atlantic Ave., 1st Floor Ste 109, Long Beach, CA 90805 | 2018-11-15 |
| 1508359605 | Mykayla Rowley | Case Manager/Care Coordinator | 5190 Atlatic Ave, Long Beach, CA 90805 | 2018-06-13 |
| 1942728589 | Marissa Liana Cabral | Social Worker | 5190 Atantic Ave, Long Beach, CA 90805 | 2017-09-04 |
| 1245757673 | Karina Vasquez | Licensed Vocational Nurse | 1325 E Poppy St, Long Beach, CA 90805 | 2017-08-25 |
| 1376060277 | Rebekkah Dawn Williams | Counselor | 100 East Market Street, Long Beach, CA 90805 | 2017-08-23 |
| 1871038919 | Andrea Dabbs | Pharmacist | 3700 E. South St., Lakewood, CA 90805 | 2016-12-28 |
| 1164972360 | Young Men's Christian Association of Greater Long Beach | Health Educator | 4949 Atlantic Ave, Long Beach, CA 90805 | 2016-10-12 |
| 1043662158 | Kristina Eunjeong Chang | Podiatrist | 3700 E South Street, Lakewood, CA 90805 | 2016-07-13 |
| Find all providers in zip 90805 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114534526 | Lakeysher Swantima Whitfeld | Counselor | 1225 E 3rd St Apt A, Long Beach, CA 90802-3670 | 2020-09-29 |
| 1467061457 | Alex Glowacki | Counselor | 212 Euclid Ave Apt 102, Long Beach, CA 90803-6033 | 2020-07-27 |
| 1154960441 | Asopaepae Ropeti Mulitauaopele | Counselor | 2720 E 56th St, Long Beach, CA 90805-5104 | 2020-01-03 |
| 1689212029 | Brian Scott Becher | Counselor | 4427 E Anaheim St # B, Long Beach, CA 90804-3115 | 2019-12-17 |
| 1134774912 | Asucena Leon | Counselor | 2140 W Wardlow Rd Apt 3, Long Beach, CA 90810-2059 | 2019-08-07 |
| 1649746215 | Cassandra Whitney Dewey | Counselor | 2120 W. Williams Street, Long Beach, CA 90810 | 2018-10-22 |
| 1598240442 | Elle Whitney Anzalone | Counselor | 6502 E Wardlow Rd, Long Beach, CA 90808-4137 | 2018-09-26 |
| 1114404407 | Anthony Sison | Counselor | 1358 Ximeno Ave, Long Beach, CA 90804-3045 | 2018-07-19 |
| 1073026738 | Latrisha S. Stewart | Counselor | 2120 W Williams St Unit 31, Long Beach, CA 90810-3636 | 2017-11-15 |
| 1316462484 | Kathlyn Pearl Parlet | Counselor | 351 E. 6th. Street, Long Beach, CA 90802 | 2017-08-09 |
| Find all providers in LONG BEACH | ||||
| City | LONG BEACH |
| Zip Code | 90805 |
Please comment or provide details below to improve the information on PERRY WAGNER.
| 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.