Active NPI
Seth Wagerman, PHD
- Psychologist
- Simi Valley, CA
National Provider Identifier
1346099546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY34847
- Practice address
- PO Box 494
Simi Valley, CA 93062-0494 - Phone
- (657) 206-2402
- NPI assigned
- May 18, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY34847 | CA | Primary |
Addresses
Primary practice location
PO Box 494
Simi Valley, CA 93062-0494
Mailing address
PO Box 494
Simi Valley, CA 93062-0494
Phone (657) 206-2402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 21, 2024 through Aug 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY34847 | CA | MD | Psychologist |
| 34847 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1346099546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 494",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930620494",
"telephone_number": "657-206-2402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 494",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930620494",
"telephone_number": "657-206-2402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGERMAN",
"first_name": "SETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-18",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY34847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.