Individual
KELVIN KIM WAGLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7178 S RECOVERY RD, FRANCH CAMP, CA 95231-9523
(209) 468-6208
Mailing address
7178 S RECOVERY RD, FRANCH CAMP, CA 95231
(209) 468-6208
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
20189
CA
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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