| Kenyada Marie Wagoner, LCSW | |
|
3939 13th St, Riverside, CA 92501-3505 | |
| (951) 214-5071 | |
| Not Available |
| Full Name | Kenyada Marie Wagoner |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 3939 13th St, Riverside, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760172688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 114731 (California) | Primary |
| Entity Name | Community Health Systems Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952308009 PECOS PAC ID: 7012824717 Enrollment ID: O20051117000822 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenyada Marie Wagoner, LCSW 315 E Esplanade Ave # 1581, San Jacinto, CA 92583-5102 Ph: (951) 214-5071 | Kenyada Marie Wagoner, LCSW 3939 13th St, Riverside, CA 92501-3505 Ph: (951) 214-5071 |
Mrs. Jacqueline S Ashley, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7140 Indiana Ave, Riverside, CA 92504 Phone: 951-358-6000 | |
Cristina Flores Hubb, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3499 10th St, Riverside, CA 92501 Phone: 951-955-1560 | |
Jessica Elizabeth Wilinski, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2085 Rustin Ave Bldg 4, Riverside, CA 92507 Phone: 951-955-8000 | |
Lisa Stokes, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4996 La Sierra Ave, Riverside, CA 92505 Phone: 951-525-3752 | |
Deren Leland Mikels, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5015 Canyon Crest Dr, Suite 102, Riverside, CA 92507 Phone: 951-529-3692 Fax: 951-346-3780 | |
Mrs. Kristin Jean Miller, M.S.W Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2085 Rustin Ave, Riverside, CA 92507 Phone: 951-715-5040 Fax: 951-784-4976 | |
Luis Roberto Bravo, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1827 Atlanta Ave Ste D3, Riverside, CA 92507 Phone: 951-955-8000 |