Debra Wagner, M.A., M.F.T.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 45870 Issued in CA

Practice address

23690 N Highway 1
Fort Bragg, CA 95437-8422

Phone

(707) 734-0153

NPI assigned

Feb 21, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Debira Branscombe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1922277243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23690 N HIGHWAY 1",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378422",
            "telephone_number": "707-734-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23690 N HIGHWAY 1",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954378422",
            "telephone_number": "707-734-0153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "DEBRA",
        "credential": "M.A., M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 45870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBIRA",
            "last_name": "BRANSCOMBE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tadeus Ulatowski, DDS
• Lynn Unroe
• Jennifer C Van Wormer
• Kei Julia Velazquez, CNM
• Kathryn Elaine Voskuyl
• Sarah Wagner
• Cynthia Lynn Wall, LCSW
• John T Wallace II, MD
• Lindsay Aden Wansbury, MFT
• Magdalena Weinstein

• Marriage & Family Therapist in Fort Bragg, CA
• Providers in Fort Bragg, 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 May 20, 2021; 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.