Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
IMOGEN WORMWOOD
ActiveIMOGEN WORMWOOD is a Local Education Agency healthcare provider located in SANTA ROSA, California. NPI 1669046389 is currently active in the NPPES registry. Verify at CMS.
Local Education Agency · SANTA ROSA, CA
Registration Details
- NPI Number
- 1669046389
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 17, 2021 (5.2000576333881 yrs)
- Last Updated
- Sep 4, 2025
Practice Information
- Address
-
4415 SONOMA HWYSANTA ROSA, CA, 954097100Browse CA providers · Browse ZIP 95409
- Phone
- 7073270909
- Primary Specialty
-
Local Education Agency
251300000X
- Additional Specialty
- Mental Health Counselor
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.