MR. BRET PAUL WANGAN (NPI# 1174689863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174689863 |
Entity Type | Individual |
Full Name | MR. BRET PAUL WANGAN |
Credential | LCSW |
Practice Address |
970 Reserve Dr Suite 205 Roseville CA 95678-1376 |
Mailing Address |
4327 Golden Center Dr Placerville CA 95667-6287 |
Practice Telephone | 9167801070 |
Practice Fax Number | 9167801199 |
Mailing Telephone | 5306217322 |
Mailing Fax Number | 5306217707 |
Enumeration Date | 2006-12-28 |
Last Update Date | 2011-05-13 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
20785 | CA | Behavioral Health & Social Service Providers |
Street Address |
970 RESERVE DR SUITE 205 |
City | ROSEVILLE |
State | CA |
Zip Code | 95678-1376 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740253566 | Ronald A Tachibana | Family Medicine | 970 Reserve Dr, Suite 149, Roseville, CA 95678-1376 | 2006-02-10 |
1285886440 | Jason Keith Isacson | Counselor | 970 Reserve Dr, Suite 205, Roseville, CA 95678-1376 | 2008-10-21 |
1437346707 | Marla Mccall | Nurse Practitioner | 970 Reserve Dr, Suite 205, Roseville, CA 95678-1376 | 2007-10-01 |
1972657393 | Midtown Primary Care Associates Medical Group, Inc. | Family Medicine | 970 Reserve Dr, Suite 149, Roseville, CA 95678-1376 | 2007-01-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
1396378980 | David F Shirley M D P C | Family Medicine | 4001 Impala Circle, Roseville, CA 95678 | 2020-02-21 |
1083256051 | Rosemary Ellen Robben | Community Health Worker | Cirby Wellness Center 101 Cirby Hills Drive, Roseville, CA 95678 | 2019-10-11 |
1588217236 | Kaiser Foundation Health Plan Inc | Pharmacy | 1021 Riverside Ave, Roseville, CA 95678 | 2019-07-22 |
1174093793 | Neftali Hernandez | Behavior Technician | 1100 Roseville Parkway Apt 1021, Roseville, CA 95678 | 2018-11-26 |
1467951798 | Amarantha Martinez | Behavior Technician | 1900 Quail Ridge Road, #99, Roseville, CA 95678 | 2018-02-01 |
1093231276 | Compassionate Home Health, Ltd | Home Health | 1100 Melody Lane, Suite 106, Roseville, CA 95678 | 2017-08-18 |
1629598891 | Jimena Andrade Martins | Behavior Technician | 602 Atkinson Street, Roseville, CA 95678 | 2017-06-20 |
1891221057 | Zride Inc | Taxi | 106 Church Street, Suite 2, Roseville, CA 95678 | 2017-05-10 |
1568997641 | Joline Trinh | Pharmacist | 1030 Pleasant Grove Boulevard, Roseville, CA 95678 | 2017-04-26 |
Find all providers in zip 95678 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750999629 | Cedar Rose Lundgren | Counselor | 1611 County Road B W Ste 204, Roseville, MN 55113-4053 | 2020-07-16 |
1720645443 | Michele Marie Villarreal | Counselor | 720 Sunrise Ave Ste 200c, Roseville, CA 95661-4508 | 2019-05-29 |
1346803038 | Anna D Scanlan | Counselor | 1711 County Road B W Ste 108s, Roseville, MN 55113-4036 | 2019-04-17 |
1356804702 | Ronald Ramsey | Counselor | 30581 Hidden Pines Ln # 30581, Roseville, MI 48066-7301 | 2019-04-12 |
1295295509 | Stephen Douglas Smith | Counselor | 2591 Parkcrest Way, Roseville, CA 95747-7140 | 2019-03-22 |
1104384825 | Gene H Burns | Counselor | 300 Harding Blvd Ste 116c, Roseville, CA 95678-2472 | 2019-03-12 |
1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
1043775109 | Ryan Jibson | Counselor | 420 Folsom Rd Ste D, Roseville, CA 95678-2767 | 2019-02-04 |
1649745837 | Courtney Jean Smith | Counselor | 257 Cedar St, Roseville, CA 95678-2539 | 2018-10-04 |
1033655568 | Naquiela Buckner I | Counselor | 1780 Vernon St, Roseville, CA 95678-6311 | 2017-01-08 |
Find all providers in ROSEVILLE |
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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.