MEDICARE: WADE M SONGER

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	373H00000X	Day Training/Habilitation Specialist		CA

General Provider Information

NPI Number	:	1700763836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WADE M SONGER

Provider Business Mailing Address
First Line	:	490 SONOMA MOUNTAIN RD
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94954-9579
Country	:	US
Telephone Number	:	510-896-0592
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 PETALUMA BLVD S
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94952-5545
Country	:	US
Telephone Number	:	707-765-8488
Fax Number	:

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

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	06/13/2026

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Directions to “ WADE M SONGER ” Practice Location

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