Tessa Waggoner, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

24735 Issued in CA

Practice address

77 Rolling Oaks Dr Ste 100
Thousand Oaks, CA 91361-1017

Phone

(805) 285-3562

Fax

(805) 364-4947

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Larry Brown D/B/a Coast Physical Therapy Spec

  • Specialist
  • Oxnard, CA
  • NPI 1871710814
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1003033846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 PEDRO ST",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930107739",
            "telephone_number": "805-285-3562",
            "fax_number": "805-364-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ROLLING OAKS DR STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611017",
            "telephone_number": "805-285-3562",
            "fax_number": "805-364-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "659 Pedro St",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930107739",
            "country_code": "US",
            "telephone_number": "805-285-3562",
            "fax_number": "805-364-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "TESSA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "24735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vons Companies Inc
• Vons Companies Inc
• Gary Scott Voorman, M.D.
• Victoria Anne Voshell, RN
• David Duc-Tuan Vu, PHARMD
• Hogan Wagner, BA
• Sean B Wagner, D.C.
• Jeff Waldberg, PT, MOMT
• Glenn Eric Waldman, M.D.
• Donald Waldrep, M.D.

• Specialist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.