Cortney Paige Wagner, M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC43797 Issued in CA

Practice address

11555 Los Osos Valley Rd Ste 210
San Luis Obispo, CA 93405-6417

Phone

(805) 334-0863

NPI assigned

Mar 26, 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1245358597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 LOS OSOS VALLEY RD STE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056417",
            "telephone_number": "805-334-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 LOS OSOS VALLEY RD STE 210",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934056417",
            "telephone_number": "805-334-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "CORTNEY",
        "middle_name": "PAIGE",
        "name_prefix": "Mrs.",
        "credential": "M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Christine Vosburg, PSY.D.
• Justin E Vose
• Kathleen J Waddell, PHD
• Tina L Waggoner
• Cherish Wagner
• Rachael Mae Wahl, LVN
• Taylor Suzanne Wahl, PA-C
• Rose Charlotte Wakeland
• Anna Katrina Walden
• Nancy J Walden, FNP

• Marriage & Family Therapist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.