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KENYADA MARIE WAGONER LCSW
NPI 1760172688
Social Worker - Clinical in Riverside, CA

Active since May 12, 2023PECOS Enrolled
3939 13TH ST, RIVERSIDE, CA 92501(951) 214-5071 Get Directions Write a Review

NPPES record last updated: May 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenyada Marie Wagoner Lcsw NPPES

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

KENYADA MARIE WAGONER LCSW (NPI 1760172688) is an individual clinical provider in Riverside, California, licensed in California (114731) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1760172688
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKENYADA MARIE WAGONERCredential: LCSW
Location Address3939 13TH STRiverside, CA 92501-3505
Mailing Address315 E Esplanade Ave # 1581San Jacinto, CA 92583-5102 · (951) 214-5071
Phone(951) 214-5071
Sole ProprietorYes
Enumeration DateMay 12, 2023
NPPES CertifiedMay 12, 2023
✔ NPI 1760172688 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 114731
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.
3939 13TH ST, Riverside, CA 92501
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenyada Marie Wagoner Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92501 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

CELENNIA ESQUIVEL
Student in an Organized Health Care Education/Training Program
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-4314
CRISTINA GERONIMO
Behavior Technician
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 236-9179
ALLISON KLECKER MA,SLP-CCC
Speech-Language Pathologist
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6476
MR. ROBERT JOHN NAVARRO OTR/L
Occupational Therapist
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6476
JULIANNA BUI
Occupational Therapist
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6476
TERI ROBIN GARCIA
Behavior Technician
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6480
ALLYSON FORD
Behavior Technician
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6666
RIVERSIDE COUNTY SUPERINTENDENT OF SCHOOLS
Local Education Agency (LEA)
3939 13TH ST
RIVERSIDE, CA 92501
Riverside County (951) 826-6602

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 Kenyada Wagoner's NPI number?

The NPI number for Kenyada Wagoner is 1760172688. It was assigned to this individual provider in the NPPES registry on May 12, 2023.

Where is Kenyada Wagoner located?

Kenyada Wagoner practices at 3939 13th St, Riverside, CA 92501. The listed phone number is (951) 214-5071.

What is Kenyada Wagoner's specialty?

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

Is Kenyada Wagoner enrolled in Medicare?

Yes. Kenyada Wagoner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenyada Wagoner was last updated on May 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.