Paul Phillip Wager Jr., MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT 38677 Issued in CA

Practice address

161 Avenida Cabrillo
San Clemente, CA 92672-4040

Phone

(949) 285-5486

NPI assigned

Apr 23, 2007

Sex

Male

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1952333460
  NPD

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336367267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-285-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 AVENIDA CABRILLO",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724040",
            "telephone_number": "949-285-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGER",
        "first_name": "PAUL",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT 38677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Jason Viola, OTR/L
• John Allen Virag, DC
• Anna Visser
• John Robert Vogt, D.C.
• Seema Wadhwani, PTA
• Burton Wagner, D.C.
• Garrett Torres Wagner
• Kerry Grimes Wagner, MPT
• Veronique Emma Wagner, D.C
• Cinthia Irene Walker, PMHNP

• Marriage & Family Therapist in San Clemente, CA
• Providers in San Clemente, 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 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.