Organization
ANDREA M WAGNER PSYCHOLOGIST PC
Active
Parent organization
ANDREA M WAGNER PSYCHOLOGIST PC
Other names
Redeemed Mental Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANDREA M WAGNER PSYCHOLOGIST PC
Authorized official
DR. ANDREA MARIE WAGNER PSY.D. (OWNER)
(949) 447-8257
Entity
Organization
Contact information
Practice address
456 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4211
(949) 447-8257
(949) 203-6158
Mailing address
456 OLD NEWPORT BLVD, NEWPORT BEACH, CA 92663-4211
(949) 447-8257
(949) 209-0357
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
08/08/2024
Last updated
05/12/2026
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