JEFFREY WAGNER LPCC
NPI 1255731402
Counselor - Professional in San Diego, CA

Active since August 25, 2014
2865 LOGAN AVE, SAN DIEGO, CA 92113(619) 232-4357 Get Directions Write a Review

NPPES record last updated: October 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 22, 2022, Jan 29, 2021, Oct 31, 2018 (3 updates tracked since 2018).

About Jeffrey Wagner Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY WAGNER LPCC (NPI 1255731402) is an individual professional provider in San Diego, California, licensed in California (11955) and active in the NPI registry since August 2014.

NPPES Registry Identity

NPI1255731402
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameJEFFREY WAGNERCredential: LPCC
Location Address2865 LOGAN AVESan Diego, CA 92113-2411
Mailing Address2865 Logan AveSan Diego, CA 92113-2411 · (619) 232-4357
Sole ProprietorNo
Enumeration DateAugust 25, 2014
Last NPPES UpdateOctober 30, 20253 updates tracked since enumeration
NPPES CertifiedOctober 30, 2025
NPI 1255731402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License Licensed in CA · 11955
2865 LOGAN AVE, San Diego, CA 92113

Other Identifiers 1

Medicaid37378100CA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
2865 LOGAN AVE
SAN DIEGO, CA 92113
Licensed Vocational Nurse
2865 LOGAN AVE
SAN DIEGO, CA 92113
Student in an Organized Health Care Education/Training Program
2865 LOGAN AVE
SAN DIEGO, CA 92113
Student in an Organized Health Care Education/Training Program
2865 LOGAN AVE
SAN DIEGO, CA 92113
Social Worker (Clinical)
2865 LOGAN AVE
SAN DIEGO, CA 92113
Case Manager/Care Coordinator
2865 LOGAN AVE
SAN DIEGO, CA 92113
Counselor (Mental Health)
2865 LOGAN AVE
SAN DIEGO, CA 92113
Student in an Organized Health Care Education/Training Program
2865 LOGAN AVE
SAN DIEGO, CA 92113

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffrey Wagner's NPI number?

The NPI number for Jeffrey Wagner is 1255731402. It was assigned to this individual provider in the NPPES registry on August 25, 2014.

Where is Jeffrey Wagner located?

Jeffrey Wagner practices at 2865 Logan Ave, San Diego, CA 92113. The listed phone number is (619) 232-4357.

What is Jeffrey Wagner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Jeffrey Wagner was last updated on October 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.