DR. ANDREA WAGNER NPI 1366995078

NPI Information

  • NPI: 1366995078
  • Provider Name: DR. ANDREA WAGNER
  • Classification: Psychologist - 103TF0200X
  • Specialization: Forensic
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 456 OLD NEWPORT BLVD
    NEWPORT BEACH, CA
    ZIP 92663
  • Phone: (949) 447-8257

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NPI Details

DR. Andrea Wagner is a forensic psychologist in Newport Beach, CA. The provider is a psychologist whose specialty is characterized by activities primarily intended to provide professional psychological expertise within the judicial and legal systems. DR. Andrea Wagner NPI is 1366995078. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

456 OLD NEWPORT BLVD
NEWPORT BEACH, CA
ZIP 92663-211
Phone: (949) 447-8257

The NPI 1366995078 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/28/2016 and was last updated on 5/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TM1800XPsychologistIntellectual and Developmental DisabilitiesCALIFORNIANo
2103TF0200XPsychologistForensicYes
3103TC0700XPsychologistClinical32730CALIFORNIANo
4103TA0400XPsychologistAddiction (Substance Use Disorder)CALIFORNIANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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