Wagner, Shaun

Wagner, Shaun is an sole proprietor health care provider with primary practice located at 9808 Venice Blvd Suite 700, Culver City CA 90232-2732. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Wagner, Shaun can be contacted via phone (310) 945-3350.

Contact Information

Primary practice address
9808 Venice Blvd Suite 700 Culver City CA 90232-2732
Phone: (310) 945-3350
Fax: (310) 945-3356
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 443697 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 95021557 California

Profile Details

NPI number 1518281336
LBN Legal business name Wagner, Shaun
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 23rd, 2010
Last updated May 16th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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