JESSE WAGNER

SANTA CRUZ, CA
NPI1669030631
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
Additional Taxonomies101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2019-06-04
Last Update Date2019-06-04
Business Address
JESSE WAGNER
380 ENCINAL ST STE 200
SANTA CRUZ, CA 95060-2178
Phone number: 831-469-1700
Mailing Address
JESSE WAGNER
380 ENCINAL ST STE 200
SANTA CRUZ, CA 95060-2178
Phone number: 831-469-1700
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