Annie Gene Banks Wardle, MSW
Counselor, Mental Health in Manteca, CA. Individual provider (NPI-1).
NPI number1023716404
StatusActive
Last updated in NPPESFeb 16, 2023
Details
- NPI
- 1023716404
- Entity type
- Individual (NPI-1)
- Name
- Annie Gene Banks Wardle
- Credential
- MSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 16, 2023
- Certification date
- Feb 15, 2023
- Last updated
- Feb 16, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
763 Orchard WayManteca, CA 95336-3553
Phone 209-637-7310
Mailing address
763 Orchard WayManteca, CA 95336-3553
Phone 209-637-7310
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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