Brittany Michelle Wagner

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APCC16453 Issued in CA

Practice address

16552 Sunhill Dr
Victorville, CA 92395-4518

Phone

(760) 780-4400

NPI assigned

Jul 30, 2024

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

Other names 1

• Brittany Michelle Embrey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Valley Star Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Downey, CA
  • NPI 1396491973
  NPD (past)
• Valley Star Behavioral Health, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Victorville, CA
  • NPI 1902393317
  NPD (past)

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1104655877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20301 PIMA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085124",
            "telephone_number": "760-267-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16552 SUNHILL DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954518",
            "telephone_number": "760-780-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "BRITTANY",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC16453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "EMBREY",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adam Vollandt
• Irene Vong
• Marsha Vonlinsowe
• Vons Companies Inc
• Vvipa Medical Group Inc
• Jessica Waite
• Wal-Mart Stores, Inc
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walgreen Co

• Mental Health Counselor in Victorville, CA
• Providers in Victorville, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.