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

Mary Wagner-Davis, IBCLC

Individual provider Marriage & Family Therapist · NPI 1649697475

Mary Wagner-Davis, IBCLC is a Marriage & Family Therapist in Roseville, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

604 Fifteen Mile Dr
Roseville, CA 95678-5921
Phone: (916) 276-8016
Show map & directions

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

Specialties & licences

Lactation Consultant (Non-RN) (primary) Taxonomy 174N00000X · Licence 10218838 (CA)
Marriage & Family Therapist Taxonomy 106H00000X · Licence MFC23253 (CA)

Record details

NPI number1649697475
Entity typeIndividual (Type 1)
GenderFemale
Credentials IBCLC
Sole proprietorYes
NPI enumeratedMarch 18, 2014
Last updated in NPPESMarch 18, 2014

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