Individual
MELISSA WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2750 SUTTERVILLE RD, SACRAMENTO, CA 95820-1024
(916) 290-8239
Mailing address
2750 SUTTERVILLE RD, SACRAMENTO, CA 95820-1024
(916) 290-8239
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPCC18526
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2019
Last updated
08/12/2025
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