Active NPI
Dale Ann Wagner, MFT
- Mental Health Counselor
- Oxnard, CA
National Provider Identifier
1003932658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 38361
- Practice address
- 1911 Williams Dr Ste 150
Oxnard, CA 93036-2612 - Phone
- (805) 981-8484
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 38361 | CA | Primary |
Addresses
Primary practice location
1911 Williams Dr Ste 150
Oxnard, CA 93036-2612
Mailing address
PO Box 52302
Oxnard, CA 93031-2302
Phone (805) 981-8484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38361 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003932658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52302",
"city": "OXNARD",
"state": "CA",
"postal_code": "930312302",
"telephone_number": "805-981-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1911 WILLIAMS DR STE 150",
"city": "OXNARD",
"state": "CA",
"postal_code": "930362612",
"telephone_number": "805-981-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGNER",
"first_name": "DALE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "38361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxnard, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.