| Doctor Name: | MS. DALE ANN WAGNER |
| NPI Number: | 1003932658 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MFT |
| License Number: | 38361 |
| Business Practice Address: | 1911 Williams Dr Ste 150 Oxnard, CA - 930362612 |
| Business Phone Number: | 8059818484 |
| Business Fax Number: | |
| Mailing Address: | Po Box 52302, OXNARD |
| State: | CA |
| Postal Code: | 930312302 |
| Phone Number: | 8059818484 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 38361 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |