Individual
DR. MICHAEL S WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., LMFT
Contact information
Practice address
3263 SACRAMENTO ST, SUITE B, SAN FRANCISCO, CA 94115-2054
(415) 775-2533
Mailing address
3263 SACRAMENTO ST, SUITE B, SAN FRANCISCO, CA 94115-2054
(415) 775-2533
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
MFC23782
CA
106H00000X
Marriage & Family Therapist
MFC23782
CA
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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