Active NPI
Kathryn Wagenbach, PHARMD, RPH
- Pharmacist
- Moorpark, CA
National Provider Identifier
1477839868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 63413
- Practice address
- 140 W Los Angeles Ave
Moorpark, CA 93021-1897 - Phone
- (805) 529-9601
- Fax
- (805) 529-9607
- NPI assigned
- Oct 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63413 | CA | Primary |
Addresses
Primary practice location
140 W Los Angeles Ave
Moorpark, CA 93021-1897
Mailing address
140 W Los Angeles Ave
Moorpark, CA 93021-1897
Phone (805) 529-9601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63413 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319846400000",
"number": "1477839868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 W LOS ANGELES AVE",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930211897",
"telephone_number": "805-529-9601",
"fax_number": "805-529-9607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 W LOS ANGELES AVE",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930211897",
"telephone_number": "805-529-9601",
"fax_number": "805-529-9607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENBACH",
"first_name": "KATHRYN",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-29",
"last_updated": "2011-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "63413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorpark, CA
- Jeffrey Raymond Vargo IX, PT
- Justin Anthony Velasco
- Ventura County Community College District (Moorpark College, Student Health Services)
- Nhat Cong Vo, M.D.
- Julie Von Mulldorfer, OTR/L
- Walgreen Co (Walgreens #10738)
- Michel A Wall, PA-C
- Alice Mumbi Wambaa
- Shiulan Wang, LAC
- Lana Louie A. Wania-Galicia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.