| Abagail Rose Waight, MS | |
|
18700 Oxnard St, Tarzana, CA 91356-1413 | |
| (818) 654-3950 | |
| Not Available |
| Full Name | Abagail Rose Waight |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 18700 Oxnard St, Tarzana, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598320103 | NPI | - | NPPES |
| MXD840427499 | Other | TX | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Entity Name | Soultenders Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164617007 PECOS PAC ID: 6507170453 Enrollment ID: O20150917001766 |
| Mailing Address | Practice Location Address |
|---|---|
| Abagail Rose Waight, MS 6200 De Soto Ave Apt 35307, Woodland Hills, CA 91367-0204 Ph: (215) 285-9998 | Abagail Rose Waight, MS 18700 Oxnard St, Tarzana, CA 91356-1413 Ph: (818) 654-3950 |
Nicole Marian Johnstone, RADT Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 818-654-3950 | |
Gregory Paul Walsh, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 818-996-1051 | |
Sara Andrea Vides, RADT Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 818-996-1051 | |
David Heiserman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 747-224-0384 Fax: 818-960-4087 | |
Miss Shannon Mehdian, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 310-422-8991 | |
Alene Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 818-996-1051 | |
Adrian L Payne, Counselor Medicare: Not Enrolled in Medicare Practice Location: 18646 Oxnard St, Tarzana, CA 91356 Phone: 818-996-1051 |