Individual
ALEXA HAYDEE WAGGONER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3877 12TH ST, RIVERSIDE, CA 92501-3578
(951) 742-5044
Mailing address
17973 GRAPEVINE LN, SAN BERNARDINO, CA 92407-8928
(909) 695-9269
(909) 695-9269
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
CA
Other
Enumeration date
04/03/2026
Last updated
04/03/2026
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