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Individual

KRISTI LYNN WAGNER-STEH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
300 MEDICAL PLAZA, B200, LOS ANGELES, CA 90095-0001
(310) 825-6183
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 794-1195
(310) 794-7491

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY21167
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY21167
CA
Enumeration date
02/27/2008
Last updated
04/19/2012
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