JASON WAGNER (NPI# 1093014334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093014334 |
| Entity Type | Individual |
| Full Name | JASON WAGNER |
| Practice Address |
360 Whiskey Hill Rd Watsonville CA 95076-8521 |
| Practice Telephone | 8317249333 |
| Mailing Telephone | 8317249333 |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2011-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SANTA CRUZ COUNTY MEDICARE GROUP PTAN# | ZZZ91892Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053700765 | Jason Robert Wagner | Counselor | 8728 S 120 E, Sandy, UT 84070-1526 | 2015-01-19 |
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1376003517 | Jason Wagner | Student in an Organized Health Care Education/Training Program | 6431 Fannin St # 1.150, Houston, TX 77030-1501 | 2019-03-22 |
| 1720536691 | Jason Fredrick Wagner | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2016-09-20 |
| 1215329420 | Jason Wagner | Counselor | 2405 28th St, Anacortes, WA 98221-2484 | 2015-02-25 |
| 1457753519 | Jason Wagner | Physician Assistant | 2025 E Route 66, Glendora, CA 91740-4670 | 2014-09-19 |
| 1902168925 | Jason Kane Wagner | Surgery | 600 N Cattlemen Rd Ste 220, Sarasota, FL 34232-6422 | 2012-06-14 |
| 1588729768 | Jason E Wagner | Internal Medicine | 3400 Civic Center Blvd, West Pavilion 1st Fl, Philadelphia, PA 19104-5127 | 2006-12-27 |
| 1689641961 | Jason C Wagner | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2006-03-05 |
| 1972594471 | Jason Michael Wagner | Radiology | 940 Ne 13th St, Suite 4g4250, Oklahoma City, OK 73104-5008 | 2005-11-03 |
| Street Address |
360 WHISKEY HILL RD |
| City | WATSONVILLE |
| State | CA |
| Zip Code | 95076-8521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831647445 | Chloe Clarke | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-09-13 |
| 1972958957 | Samuel Salazar-cadena | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-04-27 |
| 1992159487 | Wendy Hernandez Beall | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-04-20 |
| 1952762049 | Juan Garcia | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-03-16 |
| 1730548553 | River Young | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-02-22 |
| 1457719080 | Ronda Wiley | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2016-02-10 |
| 1861865214 | Julie Ruiz | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2015-11-06 |
| 1326419938 | Stacey Pratt | Marriage & Family Therapist | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2015-10-08 |
| 1720468747 | Stephanie Elaine Vasquez | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2015-06-04 |
| 1720404809 | Elizabeth Anne Ungerecht | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2014-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757515 | Vicky E Gonzalez | Case Manager/Care Coordinator | 2714 Freedom Blvrd, Watsonville, CA 95076 | 2019-02-28 |
| 1861987059 | Encompass Community Services | Community/Behavioral Health | 2714 Freedom Blvd., Freedom, CA 95076 | 2018-06-29 |
| 1134617798 | Haven of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 107 Pauline Dr, Watsonville, CA 95076 | 2018-04-28 |
| 1346743911 | Kathleen Long | Physician Assistant | 2468, 75 Nielson St, Watsonville, CA 95076 | 2018-03-09 |
| 1811403603 | Hieu Thi Thanh Nguyen Boulom | Pharmacist | 2810 Freedom Blvd, Watsonview, CA 95076 | 2017-12-16 |
| 1649798398 | Jonathon Rank | Counselor | 335 East Lake Ave, Watsonville, CA 95076 | 2017-09-01 |
| 1841653318 | Cristina Guzman | Registered Nurse | 195 Aviation Way, Ste 200, Watsonville, CA 95076 | 2016-04-01 |
| 1013388974 | Salud Para La Gente | Clinic/Center | 195 Aviation Way, Suite 200, Watsonville, CA 95076 | 2015-10-16 |
| 1386025757 | Yaseer Yousuf Parupia | Podiatrist | 47 Penny Lane, Suite 1, Watsonville, CA 95076 | 2015-06-11 |
| 1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
| Find all providers in zip 95076 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346627833 | Guadalupe Ochoa | Counselor | 539 Bridge St, Watsonville, CA 95076-3648 | 2015-05-04 |
| 1093100935 | Diana Perezchica | Counselor | 20716 Freedom Blv, Watsonville, CA 95076 | 2015-03-30 |
| 1942605167 | Margarita Caracheo | Counselor | 1360 Whiskey Hill Road, Watsonville, CA 95076 | 2014-10-30 |
| 1033513346 | Lizette Ramos | Counselor | 70 Loughead St, Watsonville, CA 95076-5014 | 2014-10-15 |
| 1194155580 | Reina Valencia | Counselor | 227 Palm Ave, Watsonville, CA 95076-3967 | 2013-11-20 |
| 1811236599 | Luis Jimenez | Counselor | 1355 Madison St Apt 107, Watsonville, CA 95076-2745 | 2013-01-31 |
| 1174818108 | Cesar Hernandez | Counselor | 360 Whiskeyhill Road, Watsonville, CA 95076 | 2011-06-17 |
| 1306003611 | Shirley Ann Millico | Counselor | 360 Crossroads Rd., Watsonville, CA 95076 | 2008-05-22 |
| 1124208251 | Esmeralda Aguilera | Counselor | 12 West Beach Street, Watsonville, CA 95076 | 2007-11-06 |
| 1083830392 | Stephanie M Plane | Counselor | 2716 Freedom Blvd, Watsonville, CA 95076-1027 | 2007-04-17 |
| Find all providers in WATSONVILLE | ||||
| City | WATSONVILLE |
| Zip Code | 95076 |
Please comment or provide details below to improve the information on JASON 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.