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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1578351730

Jaxon Deshae Wagner, MD, MS is a Student in an Organized Health Care Education/Training Program in Stockton, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

1800 N California St
Stockton, CA 95204-6019
Phone: (209) 547-7184
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1578351730
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MS
Sole proprietorNo
NPI enumeratedApril 28, 2025
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025

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