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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JIMESHA WAGONER
NPI 1023837333
Social Worker - Clinical in Los Angeles, CA

Active since October 04, 2024
840 N AVENUE 66, LOS ANGELES, CA 90042(626) 395-7100 Get Directions Write a Review

NPPES record last updated: October 16, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 16, 2026, Jun 25, 2025, Oct 4, 2024 (3 updates tracked since 2024).

About Jimesha Wagoner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JIMESHA WAGONER (NPI 1023837333) is an individual clinical provider in Los Angeles, California, licensed in California (131874) and active in the NPI registry since October 2024.

NPPES Registry Identity

NPI1023837333
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJIMESHA WAGONER
Location Address840 N AVENUE 66Los Angeles, CA 90042-1508
Mailing Address840 N Avenue 66Los Angeles, CA 90042-1508 · (626) 395-7100
Phone(626) 395-7100
Sole ProprietorYes
Enumeration DateOctober 4, 2024
Last NPPES UpdateOctober 16, 20263 updates tracked since enumeration
NPPES CertifiedOctober 16, 2026
✔ NPI 1023837333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 131874
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedSocial WorkerTaxonomy 104100000X · License 131874 (CA)
840 N AVENUE 66, Los Angeles, CA 90042
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JENNIE M. MATHESS PSY.D.
Psychologist (Clinical)
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
RUBY A GARCIA LPT
Licensed Psychiatric Technician
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
ALICIA GUERRA
Rehabilitation Practitioner
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
MS. ROMINA MONSERRAT TEJEDA LMFT
Marriage & Family Therapist
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
MARISSA LEE LUBAG
Peer Specialist
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
MAYRA MELGOZA
Social Worker (Clinical)
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
EVELYN AVILA
Social Worker (Clinical)
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100
MALIYA GUERCY
Licensed Psychiatric Technician
840 N AVENUE 66
LOS ANGELES, CA 90042
Los Angeles County (626) 395-7100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jimesha Wagoner's NPI number?

The NPI number for Jimesha Wagoner is 1023837333. It was assigned to this individual provider in the NPPES registry on October 4, 2024.

Where is Jimesha Wagoner located?

Jimesha Wagoner practices at 840 N Avenue 66, Los Angeles, CA 90042. The listed phone number is (626) 395-7100.

What is Jimesha Wagoner's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Jimesha Wagoner was last updated on October 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.