Jennifer Wagner

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT165045 Issued in CA

Practice address

320 10TH St Ste 200
Santa Rosa, CA 95401-5291

Phone

(707) 579-0465

NPI assigned

Aug 24, 2026

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

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1508772088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 PORDON LN",
            "city": "HEALDSBURG",
            "state": "CA",
            "postal_code": "954483729",
            "telephone_number": "707-849-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 10TH ST STE 200",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015291",
            "telephone_number": "707-579-0465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT165045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Johanna Waggener, D.M.D
• Alix Vitacco Wagner, PPSC
• Andrew Stephen Wagner, MD
• Eric Wagner
• Irven Robert Wagner, O.D.
• Richard C Wagner
• Susan D. Wagner, MFT
• Madeleine Waldmann, MFT
• Walgreen Co (Walgreens #03297)
• Walgreen Co (Walgreens #06722)

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, 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 Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.