| Doctor Name: | SHEILA D WAGNER |
| NPI Number: | 1700105285 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, CN |
| License Number: | 356-7150-2 |
| Business Practice Address: | 5 Bon Air Rd #c-116 Larkspur, CA - 949391143 |
| Business Phone Number: | 4159241700 |
| Business Fax Number: | 4159241770 |
| Mailing Address: | 5 Bon Air Rd, #c-116 LARKSPUR |
| State: | CA |
| Postal Code: | 949391143 |
| Phone Number: | 4159241700 |
| Fax Number: | 4159241770 |
| NPI Enumeration Date: | 05/24/2010 |
| NPI Last Update Date: | 05/24/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 356-7150-2 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |