Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Imogen Wormwood

Individual provider Local Education Agency (LEA) · NPI 1669046389

Imogen Wormwood is a Local Education Agency (LEA) in Santa Rosa, California. Licensed in California. Registered with an NPI since 2021.

Licensed in
CA
In the registry since
2021
Specialties on file
2

Practice location Address checks out

4415 Sonoma Hwy
Santa Rosa, CA 95409-7100
Phone: (707) 327-0909
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Local Education Agency (LEA) (primary) Taxonomy 251300000X (CA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1669046389
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 17, 2021
Last updated in NPPESSeptember 4, 2025
Certification dateSeptember 4, 2025
Mailing address447 Sebastopol Ave, Santa Rosa, CA 95401-8502

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