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

Stacy Wagner

Individual provider Gerontological Nutrition Registered Dietitian · NPI 1679444756

Stacy Wagner is a Gerontological Nutrition Registered Dietitian in Mission Viejo, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2025
Specialties on file
2

Practice location Address checks out

27216 Regio
Mission Viejo, CA 92692-3287
Phone: (513) 377-7938
Show map & directions

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

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 926900 (CA)
Gerontological Nutrition Registered Dietitian Taxonomy 133VN1101X · Licence 936900 (CA)

Record details

NPI number1679444756
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 13, 2025
Last updated in NPPESSeptember 13, 2025
Certification dateSeptember 13, 2025