THOMAS HARRY WAGENSELLER (NPI# 1801037932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801037932 |
| Entity Type | Individual |
| Full Name | THOMAS HARRY WAGENSELLER |
| Practice Address |
1403 164th Ave San Leandro CA 94578-3123 |
| Mailing Address |
16627 Selby Dr San Leandro CA 94578-1235 |
| Practice Telephone | 5107924357 |
| Enumeration Date | 2009-03-19 |
| Last Update Date | 2009-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
1403 164TH AVE |
| City | SAN LEANDRO |
| State | CA |
| Zip Code | 94578-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356552756 | Beverly Williams-davis | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2007-05-25 |
| 1477822294 | Maurice Lemon Sr. | Case Manager/Care Coordinator | 1403 164th Ave, San Leandro, CA 94578-3123 | 2011-12-22 |
| 1720306517 | Gwendolyn Love | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2010-05-04 |
| 1366765919 | Sharonda Bingham | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2010-03-10 |
| 1972832061 | Tyler Everell Simpson | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2009-12-18 |
| 1023263753 | Tamara Maxine Watkins | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2008-11-21 |
| 1881859296 | Earl Lee Vargas | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2008-07-24 |
| 1922274786 | Valerie Sparrow | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2008-05-01 |
| 1891967022 | Valerie Farnsworth | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2008-03-27 |
| 1821290537 | Second Chance Ashland Center | Community/Behavioral Health | 1403 164th Ave, San Leandro, CA 94578-3123 | 2007-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952886327 | Keyla Itzel Monroy Rodriguez | Behavioral Analyst | 900 143rd Ave, Apt 269, San Leandro, CA 94578 | 2018-10-01 |
| 1962938340 | Shaylah Rigmaiden | Counselor | 3847 E14th St, #215, San Leandro, CA 94578 | 2017-05-04 |
| 1861864449 | Laurence Tang | Pharmacist | 13847 E. 14th Street, San Leandro, CA 94578 | 2015-10-22 |
| 1902227481 | Marissa Phan | Pharmacist | 15555 E. 14th Street #400, San Leandro, CA 94578 | 2013-12-30 |
| 1629403993 | Carly Renee Lucas | Counselor | 2257 Arlington Dr., San Leandro, CA 94578 | 2013-09-05 |
| 1871933317 | Javier Huerta | Counselor | 16335 E. 14th St, San Leandro, CA 94578 | 2013-06-28 |
| 1710231717 | Farida M Ismail | Non-emergency Medical Transport (VAN) | 1601 165th Ave, 107, San Leandro, CA 94578 | 2012-10-30 |
| 1487901989 | Amanda Dupuis | Counselor | 15942 Footlhill Blvd, San Leandro, CA 94578 | 2012-08-14 |
| 1629323506 | Mei Xiu Chua | Counselor | 13666 East 14th Street, San Leandro, CA 94578 | 2012-07-17 |
| 1730445644 | Nisreen Mesiwala Kothari | Ophthalmology | 15051 Hesperian Blvd Ste A, San Leandro, CA 94578 | 2012-04-04 |
| Find all providers in zip 94578 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194385278 | Anthony Tahon Bass | Counselor | 15480 Foothill Blvd, San Leandro, CA 94578-1009 | 2019-06-19 |
| 1730514605 | Lafreshia Brown | Counselor | 1271 Washington Ave # 730, San Leandro, CA 94577-3646 | 2013-09-10 |
| 1619148525 | Linda Blaine | Counselor | 2035 Fairmont Drive, San Leandro, CA 94578 | 2008-03-19 |
| 1114109675 | Lorraine Vivian Savage | Counselor | 474 Dolores Ave, #306, San Leandro, CA 94577-5062 | 2007-11-27 |
| 1316146160 | Geri Tyndall-funk | Counselor | 408 Dutton Ave, San Leandro, CA 94577-2808 | 2007-07-12 |
| 1790988699 | Xanthippe B. Walker | Counselor | 15970 E 14th St, Suite 4, San Leandro, CA 94578-3018 | 2007-06-07 |
| 1356552756 | Beverly Williams-davis | Counselor | 1403 164th Ave, San Leandro, CA 94578-3123 | 2007-05-25 |
| 1023228442 | Elizabeth Kathleen Shue | Counselor | 931 Arthur Ave, San Leandro, CA 94577-1405 | 2007-05-23 |
| 1215147640 | Stephanie Lynn Vizcaino | Counselor | 1417 Thrush Ave, San Leandro, CA 94578-2063 | 2007-05-23 |
| 1851991780 | Jennifer Nancy Prince | Counselor | 2035 Fairmont Dr, San Leandro, CA 94578-1088 | 2020-10-29 |
| Find all providers in SAN LEANDRO | ||||
| City | SAN LEANDRO |
| Zip Code | 94578 |
Please comment or provide details below to improve the information on THOMAS HARRY WAGENSELLER.
| 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.