Individual provider · Type 1 NPI

Tina L. Waggoner

Mental Health Counselor · San Luis Obispo, CA

NPI number 1407547490 Active

Practice location

784 High St
San Luis Obispo, CA 93401-5243

Call (805) 540-6500 Map

Fax (805) 540-6501

Mailing address

PO Box 15408
San Luis Obispo, CA 93406-5408

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1407547490

Tina L. Waggoner's National Provider Identifier is 1407547490, issued on May 19, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in San Luis Obispo, CA. The record was last updated on May 19, 2023.