Alexandria Wagner, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-17-26547 Issued in CA

Practice address

2338 W Royal Palm Rd Ste J
Phoenix, AZ 85021-9339

Phone

(925) 899-1022

NPI assigned

Aug 24, 2017

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

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1972020659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 89TH ST STE 306",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151656",
            "telephone_number": "877-264-6747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 W ROYAL PALM RD STE J",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850219339",
            "telephone_number": "925-899-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "ALEXANDRIA",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-17-26547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reina Marcela Waggener, RDH
• Jennifer Waggoner, PTA
• Candi Virginia Wagman, RN
• Stephanie Ann Wagner Kethcart, DDS
• Adam Brian Wagner, D.C.
• Brittany Wagner
• Brittney Wagner, BCBA
• Deanna Wagner, SLP
• Holly Sunset Wagner
• Lori J Wagner, FNP

• Behavior Analyst in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.