Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dimitra Kokkalis Wagner

Individual provider Specialist · NPI 1710390919

Dimitra Kokkalis Wagner is a Specialist in San Francisco, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2014

Practice location Address checks out

324 W Portal Ave
San Francisco, CA 94127-1412
Phone: (415) 731-8080
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence A172034 (CA)

Record details

NPI number1710390919
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 4, 2014
Last updated in NPPESJune 4, 2014

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