MILDRED GAYAMO WAGNER
NPI 1508614298
Counselor - Addiction (Substance Use Disorder) in Fresno, CA

Active since May 08, 2024
2772 S MLK BLVD, FRESNO, CA 93706(559) 265-4800 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mildred Gayamo Wagner NPPES

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

MILDRED GAYAMO WAGNER (NPI 1508614298) is an individual addiction (substance use disorder) provider in Fresno, California, licensed in California (18116) and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1508614298
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMILDRED GAYAMO WAGNER
Location Address2772 S MLK BLVDFresno, CA 93706
Mailing Address2772 S MlkFresno, CA 93706 · (559) 265-4800
Sole ProprietorYes
Enumeration DateMay 8, 2024
NPPES CertifiedMay 2, 2024
NPI 1508614298 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed in CA · 18116
2772 S MLK BLVD, Fresno, CA 93706

Other Names 1

Former Name (1)Mildred Gayamo Tupe

Other Providers at the Same Location NPPES 3

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

Counselor (Addiction (Substance Use Disorder))
2772 S MLK BLVD
FRESNO, CA 93706
Counselor (Addiction (Substance Use Disorder))
2772 S MLK BLVD
FRESNO, CA 93706
Counselor (Addiction (Substance Use Disorder))
2772 S MLK BLVD
FRESNO, CA 93706

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 Mildred Wagner's NPI number?

The NPI number for Mildred Wagner is 1508614298. It was assigned to this individual provider in the NPPES registry on May 8, 2024. The provider is also known as Mildred Gayamo Tupe.

Where is Mildred Wagner located?

Mildred Wagner practices at 2772 S Mlk Blvd, Fresno, CA 93706. The listed phone number is (559) 265-4800.

What is Mildred Wagner's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Mildred Wagner was last updated on May 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.