Individual
MS. SUSAN KATALI WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6926 BROCKTON AVE, STE 9, RIVERSIDE, CA 92506-3800
(951) 788-0370
(951) 788-0390
Mailing address
26610 KALMIA AVE, MORENO VALLEY, CA 92555-1727
(951) 601-3814
Taxonomy
Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
RCP19999
CA
363AM0700X
Medical Physician Assistant
Primary
PA16194
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034312
NCCPA
GA
01
—
PA16194
STATE
CA
Enumeration date
08/17/2007
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us