Keith Harold Wagoner, COUNSELOR is a
Case Manager/care Coordinator based in Sacramento, California. Keith Harold Wagoner is licensed to practice in * (Not Available) (license number ) and his current practice location is
2150 Stockton Blvd, Sacramento, California. He can be reached at his office (for appointments etc.) via phone at
(916) 875-1000.
NPI number for Keith Harold Wagoner is 1114268588 and his current mailing address is 2150 Stockton Blvd, Sacramento, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1114268588.
Healthcare Provider's Profile
| Full Name | Keith Harold Wagoner |
|---|
| Gender | Male |
|---|
| Speciality | Case Manager/care Coordinator |
|---|
| Location | 2150 Stockton Blvd, Sacramento, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1114268588
- Provider Enumeration Date: 03/11/2013
- Last Update Date: 08/27/2024
Medical Identifiers
Medical identifiers for Keith Harold Wagoner such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1114268588 | NPI | - | NPPES |
| 101Y00000X | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | A022760416 (California) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith Harold Wagoner is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Keith Harold Wagoner, COUNSELOR
2150 Stockton Blvd,
Sacramento, CA 95817-1337
Ph: (916) 875-1000 | Keith Harold Wagoner, COUNSELOR
2150 Stockton Blvd,
Sacramento, CA 95817-1337
Ph: (916) 875-1000 |
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