VICKIE JOAN WAGNER (NPI# 1982117198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982117198 |
| Entity Type | Individual |
| Full Name | VICKIE JOAN WAGNER |
| Practice Address |
210 S De Lacey Ave Ste 110 Pasadena CA 91105-2074 |
| Practice Telephone | 6263957100 |
| Mailing Telephone | 6263957100 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Street Address |
210 S DE LACEY AVE STE 110 |
| City | PASADENA |
| State | CA |
| Zip Code | 91105-2074 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467582692 | Noemi Cristina Harnen | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2007-03-06 |
| 1003314204 | Thomas Mackey | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2018-01-23 |
| 1013424928 | Tal Medovoy | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2018-01-02 |
| 1477069771 | Naomi Choi | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-12-21 |
| 1861908436 | Abel Torres | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-12-19 |
| 1134633431 | Christopher Monroy | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-22 |
| 1255845897 | Tatiana Ewing | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-17 |
| 1619480662 | Stephanie Bobadilla | Social Worker | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-11-13 |
| 1225540271 | Mariah Gabriella Dillard | Marriage & Family Therapist | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-10-31 |
| 1821508904 | Hazel Cornejo | Rehabilitation Practitioner | 210 S De Lacey Ave Ste 110, Pasadena, CA 91105-2074 | 2017-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451697 | Tonya Michlin | Registered Nurse | 800 Fairmount Ave Ste 110, Pasadena, CA 91105 | 2018-09-17 |
| 1639674161 | David Marcus Md, Inc. | Psychiatry & Neurology | 107 S. Fair Oaks Avenue, Suite #315, Pasadena, CA 91105 | 2018-03-27 |
| 1548778541 | Elias & Jun Dental Corp | Dentist | 301 S. Fair Oaks Ave., Ste 107, Pasadena, CA 91105 | 2018-01-12 |
| 1013429745 | Whitney Catalano | Dietitian, Registered | 100 S Orange Grove Blvd, 103, Pasadena, CA 91105 | 2017-11-03 |
| 1518485630 | Marlon O Miller | Counselor | 1020 South Arroyo Parkway, Pasadena, CA 91105 | 2017-09-08 |
| 1316469976 | Alexandra Scott | Speech-Language Pathologist | 235 La Vereda Road, Pasadena, CA 91105 | 2017-07-14 |
| 1346770443 | Amanda Grace Gentz | Rehabilitation Practitioner | 210 S De Lacey, Ste 110, Pasadena, CA 91105 | 2017-06-13 |
| 1427598390 | Melina Gomez Loza | Licensed Vocational Nurse | 66 Hilburt St #2, Pasadena, CA 91105 | 2017-02-27 |
| 1588115281 | Ramon Banuelos | Rehabilitation Practitioner | 210 S. Delacey Ave Suite 110, Pasadena, CA 91105 | 2016-10-18 |
| 1922554245 | Daniel Joseph Ybarra | Student in an Organized Health Care Education/Training Program | 100 W. California Blvd. Pasadena, Ca 91105, Pasadena, CA 91105 | 2016-08-28 |
| Find all providers in zip 91105 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598372153 | Donna Shanahan, Lmft | Marriage & Family Therapist | 595 E Colorado Blvd Ste 607, Pasadena, CA 91101-2015 | 2020-09-28 |
| 1568071298 | Brigit Jeffries | Marriage & Family Therapist | 426 S Los Robles Ave Apt E, Pasadena, CA 91101-3257 | 2020-07-29 |
| 1962028886 | Yuanzen Tung | Marriage & Family Therapist | 960 E Green St Ste 114, Pasadena, CA 91106-2401 | 2020-06-17 |
| 1780208801 | Ivy Zequeira | Marriage & Family Therapist | 130 S Euclid Ave Ste 2, Pasadena, CA 91101-2471 | 2020-06-04 |
| 1376167361 | Melba Rachel Mathew | Marriage & Family Therapist | 595 E Colorado Blvd Ste 211, Pasadena, CA 91101-2028 | 2020-06-04 |
| 1275156150 | Heidi Pidcoke | Marriage & Family Therapist | 696 S Madison Ave, Pasadena, CA 91106-3830 | 2020-05-26 |
| 1952924235 | Lilit Arvahi | Marriage & Family Therapist | 711 E Walnut St Ste 407, Pasadena, CA 91101-4403 | 2020-05-21 |
| 1730724022 | Patricia Carmalt | Marriage & Family Therapist | 97 W Bellevue Dr Ste 6, Pasadena, CA 91105-2501 | 2019-11-11 |
| 1457993339 | Lilit Melik-bakhshyan | Marriage & Family Therapist | 940 E Union St Ste 102, Pasadena, CA 91106-1780 | 2019-10-12 |
| 1295384022 | Jenny Berman | Marriage & Family Therapist | 745 S Marengo Ave Ste 108, Pasadena, CA 91106-4738 | 2019-09-04 |
| Find all providers in PASADENA | ||||
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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.