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

Mildred Gayamo Wagner

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1508614298

Mildred Gayamo Wagner is an Addiction (Substance Use Disorder) Counselor in Fresno, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2024

Practice location Address checks out

2772 S Mlk Blvd
Fresno, CA 93706
Phone: (559) 265-4800
Show map & directions

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

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 18116 (CA)

Record details

NPI number1508614298
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 8, 2024
Last updated in NPPESMay 8, 2024
Certification dateMay 2, 2024

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