Most Relevant Information
Provider Data
| NPI Number: | 1003259821 |
| Provider Name: | RICKI WAGNER LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 106H00000X |
| Specialty: | Marriage & Family Therapist |
| License Number: | LMFT36750 |
Most Important Dates
| Enumeration Date: | 04/10/2013 |
| Last Updated: | 04/10/2013 |
Provider Practice Location
466 RHEEM BLVD
MORAGA
CA
945562357
Practice Location Phone/Fax
| Phone: | 9252470225 |
| Fax: |
Provider Mailing Location
466 RHEEM BLVD
MORAGA
CA
945562357
Provider Mailing Phone/Fax
| Phone: | 9252470225 |
| Fax: |