TRACEY WAGNER (NPI# 1376766477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376766477 |
| Entity Type | Individual |
| Full Name | TRACEY WAGNER |
| Credential | RPT |
| Practice Address |
5601 Desoto Ave Woodland Hillsq CA 91365 |
| Mailing Address |
675 Oak Park 209 Oak Park CA 91377 |
| Practice Telephone | 8187192930 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT 26158 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386031615 | Tracey Wagner | Physician Assistant | 325 9th Ave, Harborview Medical Center, Seattle, WA 98104-2420 | 2015-04-24 |
| 1386943926 | Tracey Lynn Wagner | Pediatrics | 700 Childrens Dr, Columbus, OH 43205-2664 | 2011-03-22 |
| Street Address |
5601 DESOTO AVE |
| City | WOODLAND HILLSQ |
| State | CA |
| Zip Code | 91365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831676543 | Yana Lavrenteva | Speech-Language Pathologist | 19019 Venturay Blvd, Tarzana, CA 91365 | 2018-07-25 |
| 1215191242 | Shaaron Zaghi | Pain Medicine | 3601 De Soto Ave, Department of Pain Managment, Woodland Hills, CA 91365 | 2008-07-18 |
| 1528281680 | Diana L Jamgochyan | Physical Therapist | 5601 Desoto, Woodland Hills, CA 91365 | 2007-04-10 |
| 1932322096 | Ben D Whittaker | Physical Therapist | 5601 Desoto Ave., Woodland Hills, CA 91365 | 2007-04-10 |
| 1255454914 | Christa Maria Hernandez | Physical Therapist | 5601desotoavenue, Woodlandhills, CA 91365 | 2007-04-09 |
| 1780910620 | Vivian Chan | Pathology | 5601 De Soto Ave, Woodland Hills, CA 91365 | 2009-10-28 |
| 1841497591 | Alice Sunyoung Park | Physical Therapist | 5601 Desoto Avenue, Woodland Hills, CA 91365 | 2007-06-27 |
| 1770707432 | Debra A Hochberg | Physical Therapist | 5601 Desoto, Woodland Hills, CA 91365 | 2007-04-12 |
| 1346363348 | Justin Wade Hamilton | Physical Therapist | 5601 De Soto Ave, Kaiser Permanente, Woodland Hills, CA 91365 | 2007-04-06 |
| 1356411243 | Armine Ishtoyan | Pharmacist | 5601 De Soto Avenue, Woodland Hills, CA 91365 | 2006-11-08 |
| Find all providers in zip 91365 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063311 | Kayla Utley | Physical Therapist | 5201 Norris Canyon Rd Ste 230, San Ramon, CA 94583-5405 | 2020-11-06 |
| 1184225054 | Vuk Ekmecic | Physical Therapist | 7908 Rancho Fanita Dr Spc 23, Santee, CA 92071-3421 | 2020-11-05 |
| 1932700283 | Christopher Lui | Physical Therapist | 21621 E Bluebell Ct, Walnut, CA 91789-1443 | 2020-11-03 |
| 1952900789 | Sierra Speck | Physical Therapist | 11701 Wilshire Blvd Ste 14b1, Los Angeles, CA 90025-1547 | 2020-10-22 |
| 1992312086 | Heidi Lynne Anders | Physical Therapist | 5805 W 8th St Apt 205, Los Angeles, CA 90036-4576 | 2020-09-23 |
| 1578176780 | Patricia Isabella Commer | Physical Therapist | 4146 Randolph Ave, Oakland, CA 94602-1314 | 2020-08-26 |
| 1376151126 | Yifu Zhou | Physical Therapist | 1625 W Olympic Blvd Ste 790, Los Angeles, CA 90015-3809 | 2020-07-17 |
| 1033732250 | Sync Physical Therapy & Yoga Inc | Physical Therapist | 5100 Marlborough Dr Ste 101, San Diego, CA 92116-2020 | 2020-05-21 |
| 1043830961 | Dr. Holly Physical Therapy | Physical Therapist | 4500 Shepard St, Bakersfield, CA 93313-2326 | 2020-04-21 |
| 1861011744 | Lauren Jarmusz | Physical Therapist | 1107 2nd Ave Apt 408, Redwood City, CA 94063-4036 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | WOODLAND HILLSQ |
| Zip Code | 91365 |
Please comment or provide details below to improve the information on TRACEY 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.