MRS. LEILANI LYNN WAGNER (NPI# 1689914798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689914798 |
| Entity Type | Individual |
| Full Name | MRS. LEILANI LYNN WAGNER |
| Credential | FNP-BC |
| Practice Address |
1800 Coffee Road Suite 37 Modesto CA 95355 |
| Practice Telephone | 2095727136 |
| Practice Fax Number | 2094917595 |
| Mailing Telephone | 2095727136 |
| Mailing Fax Number | 2094917595 |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2019-08-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN966643 | DC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LX0106X |
Nurse Practitioner Specialization: Occupational Health |
95001675 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 Michigan Ave Nw, Washington, DC 20010 | 2024762035 | 2024762039 |
| Street Address |
1800 COFFEE ROAD SUITE 37 |
| City | MODESTO |
| State | CA |
| Zip Code | 95355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
| 1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
| 1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
| 1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
| 1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
| 1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
| 1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
| 1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
| 1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
| 1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
| Find all providers in zip 95355 | ||||
| Taxonomy Code | 363LX0106X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Occupational Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932707114 | Jacob Berumen | Nurse Practitioner | 1134 Lemoyne St, Los Angeles, CA 90026-3207 | 2020-10-11 |
| 1053702159 | Ivory Adanza | Nurse Practitioner | 1801 E March Ln Ste D480, Stockton, CA 95210-6681 | 2015-02-10 |
| 1427448414 | Nancy Seiler | Nurse Practitioner | 1305 Peach St Suite 301, San Luis Obispo, CA 93401-2700 | 2015-01-28 |
| 1619315165 | Christine Hovorka Weimer | Nurse Practitioner | 1515 Walnut Grove Ave, 1st Floor, Rosemead, CA 91770-3710 | 2013-06-06 |
| 1497098529 | Erin Lum | Nurse Practitioner | 77 Beale St Fl 3, Pg&e Health Center, San Francisco, CA 94105-1814 | 2013-03-27 |
| 1194019448 | Susan S Harada | Nurse Practitioner | 405 Bedford Pl, Thousand Oaks, CA 91360-5329 | 2011-06-03 |
| 1104151182 | Mary Elizabeth Murali | Nurse Practitioner | 1159 Mataro Ct, Pleasanton, CA 94566-6981 | 2009-10-08 |
| 1790946085 | Sherrill Diane Petherbridge | Nurse Practitioner | 736 W Jasmine Cir, Santa Rosa, CA 95407-6778 | 2008-06-19 |
| 1750550349 | Tammy Ann Watts | Nurse Practitioner | 5858 Stoneridge Mall Rd, Safeway Health Center, Pleasanton, CA 94588-3231 | 2008-02-27 |
| 1710182589 | Evangelina Ramirez | Nurse Practitioner | 200 Ucla Medical Plz Ste 224, Los Angeles, CA 90095-6926 | 2007-06-20 |
| Find all providers with the same taxonomy | ||||
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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.