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

Tina L Waggoner

Individual provider Mental Health Counselor · NPI 1407547490

Tina L Waggoner is a Mental Health Counselor in San Luis Obispo, California. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

784 High St
San Luis Obispo, CA 93401-5243
Phone: (805) 540-6500
Fax: (805) 540-6501
Show map & directions

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

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1407547490
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 19, 2023
Last updated in NPPESMay 19, 2023
Certification dateMay 18, 2023

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