Wagner, Andrea

Wagner, Andrea is an sole proprietor health care provider with primary practice located at 456 Old Newport Blvd , Newport Beach CA 92663-4211. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Forensic is her primary health care specialty. Wagner, Andrea can be contacted via phone (949) 447-8257.

Contact Information

Primary practice address
456 Old Newport Blvd Newport Beach CA 92663-4211
Phone: (949) 447-8257
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X California
Behavioral Health & Social Service Providers / Forensic 103TF0200X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 32730 California
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X California

Profile Details

NPI number 1366995078
LBN Legal business name Wagner, Andrea
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2016
Last updated May 23rd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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