Leilani Lynn Wagner, FNP-BC

Primary specialty

Occupational Health Nurse PractitionerTaxonomy code 363LX0106X

License

95001675 Issued in CA

Practice address

1800 Coffee Road Suite 37
Modesto, CA 95355

Phone

(209) 572-7136

Fax

(209) 491-7595

NPI assigned

Feb 26, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lwagner291811@hisp.ehr.sutterhealth.org

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1689914798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COFFEE ROAD SUITE 37",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-572-7136",
            "fax_number": "209-491-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COFFEE ROAD SUITE 37",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-572-7136",
            "fax_number": "209-491-7595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Michigan Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20010",
            "country_code": "US",
            "telephone_number": "202-476-2035 x4678",
            "fax_number": "202-476-2039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LEILANI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN966643",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "CA",
            "license": "95001675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WagnerLL@sutterhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1800 Coffee Road Suite 37",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Vinita Wadhwani, MD
• Tamim Ahmad Wafa, M.D.
• Donna Marie Wagner
• Gary Wagner, M.D.
• Karin Wagner
• Paul Brooks Wagner, C.C.P.
• Kristin Wagoner, RN
• Raed A Wahab, MD
• Stacy Waite-Ocampo, BCBA
• Daniela Waite

• Occupational Health Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Occupational Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.