Individual ProviderNatalia WagnerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1701 Divisadero St Ste 120, San Francisco, CA 94115-3011(415) 502-4444PECOS EnrollmentBased on the most recent information from CMS, provider Natalia Wagner is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1538764105Provider TypeIndividualFull NameWagner, NataliaGenderFemaleSole ProprietorNoEnumeration Date12/2/2020Last Updated8/23/2021Contact InformationPractice LocationPractice Address1701 Divisadero St Ste 120, San Francisco, CA 94115-3011Phone(415) 502-4444FaxUnlisted FaxMailing LocationMailing Address1701 Divisadero St Ste 120, San Francisco, CA 94115-3011Phone(415) 502-4444FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF346145-01New YorkCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense95017917California