Wagner, Andrea M
Wagner, Andrea M 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 / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Rehabilitation, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Wagner, Andrea M 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:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 103TA0400X | 32730 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 5083 | Connecticut |
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | 5083 | Connecticut |
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | 32730 | California |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 32730 | California |
| Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities | 103TM1800X | 32730 | California |
Profile Details
| NPI number | 1366995078 |
|---|---|
| LBN Legal business name | Wagner, Andrea M |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2016 |
| Last updated | May 21st, 2026 - about 5 months 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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