Individual
AMY WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
15696 EL CAMINO REAL #2676, RANCHO SANTA FE, CA 92067
(858) 382-7172
Mailing address
15696 EL CAMINO REAL #2676, RANCHO SANTA FE, CA 92067
(858) 382-7172
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
CA
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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