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Jason Wagner
Mental Health Counselor in Watsonville, California
NPI 1093014334

Jason Wagner is a Mental Health Counselor based in Watsonville, CA and is specialized in Mental Health. Jason Wagner practices in Watsonville, CA. The NPI Number for Jason Wagner is 1093014334 and holds a License No. (California).

The current practice location address for Jason Wagner is 360 Whiskey Hill Rd, Watsonville, CA and can be reached out via phone at 831-724-9333.

Location: 360 Whiskey Hill Rd, Watsonville, CA, 95076-8521
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093014334
Provider Name
Jason Wagner
Credential
Provider Entity Type
Individual
Gender
Male
Address
360 Whiskey Hill Rd, Watsonville, CA, 95076-8521
Phone Number
831-724-9333
Fax Number
Provider Enumeration Date
03/25/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
ZZZ91892Z 01 CA SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
institution
Provider Business Practice Location Address Details
Address
360 Whiskey Hill Rd
City
Watsonville
State
California
Zip
95076-8521
Phone Number
831-724-9333
Fax Number
person
Provider Business Mailing Address Details
Address
360 Whiskey Hill Rd
City
Watsonville
State
California
Zip
95076-8521
Phone Number
831-724-9333
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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