Sandra Laureen Wagner, PHYSICAL THERAPIST

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT Issued in CA

Practice address

30252 Tomas Ste 100
Rancho Santa Margarita, CA 92688-2181

Phone

(949) 459-1658

Fax

(949) 459-1667

NPI assigned

Jul 10, 2017

Sex

Female

Sole proprietor

No

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

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.

• Rainbow Kids Achievement Center

  • Pediatric Occupational Therapist
  • Rancho Santa Margarita, CA
  • NPI 1043465487

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1467974659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15004 204TH AVE SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980598916",
            "telephone_number": "206-409-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30252 TOMAS STE 100",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882181",
            "telephone_number": "949-459-1658",
            "fax_number": "949-459-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "SANDRA",
        "middle_name": "LAUREEN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Vogel, M.D.
• Vons Companies Inc
• Shruti S Vora, M.D.
• Elizabeth Wade, MPT
• Donna Wagner
• Walgreen Co
• Melissa Walls, DPT
• Walmart Inc.
• Crystal Walsh, LCSW
• Alexa Walthall, PHD

• Pediatric Physical Therapist in Rancho Santa Margarita, CA
• Providers in Rancho Santa Margarita, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.