Jennifer A Wagenbach

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 38348 Issued in CA

Practice address

177 Vulcan Dr
Lompoc, CA 93436-1406

Phone

(805) 733-7500

Fax

(805) 733-7510

NPI assigned

Mar 23, 2013

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

Enrolled in HI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• RP Medical LLC

  • Urgent Care Clinic/Center
  • Kahului, HI
  • NPI 1982094652
  Medicare reassignment NPD
• Focus Physical Therapy, Incorporated

  • Physical Therapist
  • Lompoc, CA
  • NPI 1891014510
  NPD (past)

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

{
    "created_epoch": "1363996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363996800000",
    "number": "1851633259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 VULCAN DR",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934361406",
            "telephone_number": "805-733-7500",
            "fax_number": "805-733-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 VULCAN DR",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934361406",
            "telephone_number": "805-733-7500",
            "fax_number": "805-733-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGENBACH",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-23",
        "last_updated": "2013-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 38348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefka A. Vladimirova
• Lorenza Vlahos
• Ankeet Jairaj Vora
• Vivian Marie Vorce, RN
• VVC Veterinary Corporation
• Wal-Mart Stores, Inc.
• Rie Waldon
• Walgreen Co
• Donna Walker, M.D.
• Walmart Inc.

• Physical Therapist in Lompoc, CA
• Providers in Lompoc, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.