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Individual

MATHEW WAGNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA PPS

Contact information

Practice address
1305 LAUREL RD, SANTA PAULA, CA 93060-1133
(805) 933-8951
Mailing address
180 ALTO DR, OAK VIEW, CA 93022-9526

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
CA

Other

Enumeration date
05/29/2025
Last updated
05/29/2025
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