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Contact Information

MATTHEW T WAGNER, CLIN. PSYCHOLOGIST
21633 AVENUE 24
CHOWCHILLA, CA93610-9650
 Phone: 559-665-6100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Health Service

103TH0100X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for MATTHEW T WAGNER · (Male)

NPI Number 1811203417
Status Active
Credentials CLIN. PSYCHOLOGIST
Entity Individual
Enumeration date 08/20/2010
Last updated 08/20/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • CA License # PSY 19277
  • CA License # PSY19277
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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