Stephanie Wagner, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

15537 Issued in CA

Practice address

4562 Westinghouse St Ste a
Ventura, CA 93003-5797

Phone

(805) 644-8255

NPI assigned

Oct 30, 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.

• Seaside Speech Therapy, Inc

  • Physical Therapy Clinic/Center
  • Ventura, CA
  • NPI 1336554260
  NPD (past)
• Seaside Speech Therapy, Inc.

  • Speech-Language Pathologist
  • Ventura, CA
  • NPI 1962796623
  NPD (past)

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509321600000",
    "number": "1477065472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 W PARK ROW AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930011873",
            "telephone_number": "805-509-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4562 WESTINGHOUSE ST STE A",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930035797",
            "telephone_number": "805-644-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "STEPHANIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CA",
            "license": "15537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Wade, M.D.
• Patricia S Wade, FNP
• Lindsay Waggerman, MD
• Allan Kosuke Wagner, DO
• Katherine Elizabeth Wagner, MD
• Susan Elizabeth Wagner, M.A., M.F.T.I.
• Samantha Sloan Waid, RN, IBCLC
• Irene Bih Wakam, MD
• Nathan Wakamoto, DPT
• Casey Wake, PSY.D.

• All providers in Ventura, CA
• Pediatric Occupational Therapist in California

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