DR. IRVEN ROBERT WAGNER (NPI# 1376687814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376687814 |
| Entity Type | Individual |
| Full Name | DR. IRVEN ROBERT WAGNER |
| Credential | O.D. |
| Practice Address |
800 Coddingtown Ctr Santa Rosa CA 95401-3511 |
| Mailing Address |
1945 Piner Rd Spc 118 Santa Rosa CA 95403-6911 |
| Practice Telephone | 7075261881 |
| Practice Fax Number | 7075422014 |
| Mailing Telephone | 7075261881 |
| Mailing Fax Number | 7075422014 |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2009-04-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WV0400X |
Optometrist Specialization: Vision Therapy |
8372TPA | CA | Eye and Vision Services Providers |
| Street Address |
800 CODDINGTOWN CTR |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95401-3511 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972148575 | Megan Elizabeth Jones | In Home Supportive Care | 1239 Eardley Ave, Santa Rosa, CA 95401 | 2019-11-07 |
| 1801447230 | Patty Macisaac | Technician | 3221 Oak Farm Lane, Santa Rosa, CA 95401 | 2019-09-26 |
| 1386114981 | Victoria Maria Guillory | Dental Hygienist | 140 Stony Point Road, Suite A, Santa Rosa, CA 95401 | 2018-11-27 |
| 1811470727 | Chemarin Eve Boyd | Student in an Organized Health Care Education/Training Program | 1260 N Dutton Avenue, 225, Santa Rosa, CA 95401 | 2018-09-07 |
| 1073008181 | Cristavel Camacho | Behavioral Analyst | 1439 Range Ave, #101, Santa Rosa, CA 95401 | 2018-06-30 |
| 1619479102 | Victoria King | Behavior Technician | 1335 N. Dutton Ave., Santa Rosa, CA 95401 | 2018-03-01 |
| 1114436060 | Lacey Lynn Palmer | Counselor | 341 Irwin Lane, Santa Rosa, CA 95401 | 2017-09-22 |
| 1720530587 | Compassionate Homecare Solutions, LLC | In Home Supportive Care | 131 A Stony Circle, Suite 500, Santa Rosa, CA 95401 | 2016-10-27 |
| 1366998981 | William Glenn | Marriage & Family Therapist | 1496 Willowside Road, Santa Rosa, CA 95401 | 2016-09-01 |
| 1790144046 | Advocacy Home Nursing, Inc | Home Health | 1400 North Dutton Avenue, Suite 20, Santa Rosa, CA 95401 | 2016-02-15 |
| Find all providers in zip 95401 | ||||
| Taxonomy Code | 152WV0400X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Vision Therapy |
| Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986014 | Johann Josue Schlager | Optometrist | 901 Dover Dr Ste 100, Newport Beach, CA 92660-5514 | 2019-08-07 |
| 1184288862 | Elizabeth Yeh | Optometrist | 970 Monument St Ste 102, Pacific Palisades, CA 90272-3860 | 2019-04-27 |
| 1558848986 | Judy Cao, Od, Inc | Optometrist | 360 E Las Tunas Dr Unit 203, San Gabriel, CA 91776-1502 | 2018-07-27 |
| 1811362718 | Dr. Robert S. Christensen Inc. | Optometrist | 250 Camino Alto, Suite 110, Mill Valley, CA 94941-1400 | 2015-12-03 |
| 1992112684 | Belinda Kuo | Optometrist | 2141 W Orangewood Ave, Suite B, Orange, CA 92868-1955 | 2014-07-15 |
| 1720410137 | Katie L Elton | Optometrist | 24640 Jefferson Ave. Suite 100, Murrieta, CA 92562 | 2013-08-08 |
| 1619147535 | Timothy Andrew Wilkins | Optometrist | 2331 Kern St, Fresno, CA 93721-2700 | 2008-03-06 |
| 1922281930 | Corinna Marie Shelley | Optometrist | 2104 W Grant Line Rd, Tracy, CA 95377-7309 | 2007-12-12 |
| 1114041746 | Allison Hongdiep Cao-le | Optometrist | 454 Alvarado St, Monterey, CA 93940-2717 | 2007-03-19 |
| 1336276757 | Cornelius Mietus | Optometrist | 1125 Coast Village Rd, Santa Barbara, CA 93108-2716 | 2007-02-27 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA |
| Zip Code | 95401 |
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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.