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

Keith Harold Wagoner, COUNSELOR

Individual provider Counselor · NPI 1114268588

Keith Harold Wagoner, COUNSELOR is a Counselor in Sacramento, California. Licensed in California. Registered with an NPI since 2013.

Licensed in
CA
In the registry since
2013
Specialties on file
3
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Practice location Address checks out

2150 Stockton Blvd
Sacramento, CA 95817-1337
Phone: (916) 875-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Counselor Taxonomy 101Y00000X · Licence A022760416 (CA)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1114268588
Entity typeIndividual (Type 1)
GenderMale
Credentials COUNSELOR
Sole proprietorNo
NPI enumeratedMarch 11, 2013
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024

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