MEDICARE: ANDREW JOSEPH HAGEMANN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	106S00000X	CA

General Provider Information

NPI Number	:	1124980644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW JOSEPH HAGEMANN

Provider Business Mailing Address
First Line	:	4315 MOUNT TAYLOR DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-6221
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4315 MOUNT TAYLOR DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-6221
Country	:	US
Telephone Number	:	707-293-8362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

Similar Medicare Providers

1285860718 — MR. RYAN JOSEPH GRUMICH
Practice Location Address:

634 PRESSLEY ST
SANTA ROSA, CA
95404-5526

Practice Phone: 707-573-6955
Practice Fax: 707-543-8176

1336003995 — KIANNA FLINN
Practice Location Address:

1120 GORDON LN
SANTA ROSA, CA
95404-5636

Practice Phone: 707-527-3249
Practice Fax:

1023100583 — MS. LORIN LIN TIERNEY MFT
Practice Location Address:

1275 4TH ST # 5053
SANTA ROSA, CA
95404-4057

Practice Phone: 707-583-9388
Practice Fax:

1376394460 — MARISSA JEANNE LECOUNT
Practice Location Address:

2455 BENNETT VALLEY RD STE B209
SANTA ROSA, CA
95404-5669

Practice Phone: 707-224-8266
Practice Fax:

1730714775 — DANIEL PEOPLES
Practice Location Address:

201 S E ST
SANTA ROSA, CA
95404-4709

Practice Phone: 707-573-6960
Practice Fax: 707-573-6961

1114889763 — TUAN QUOC PHAN LVN
Practice Location Address:

790 SONOMA AVE
SANTA ROSA, CA
95404-4713

Practice Phone: 707-544-3295
Practice Fax:

Directions to “ ANDREW JOSEPH HAGEMANN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.