Individual
MS. ANN LOUISE WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
828 S BASCOM AVE, SUITE 100, SAN JOSE, CA 95128-2651
(408) 793-5959
(408) 793-5955
Mailing address
828 S BASCOM AVE, SUITE 100, SAN JOSE, CA 95128-2651
(408) 793-5959
(408) 793-5955
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
20177
CA
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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