Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
HEALING HAVEN MENTAL HEALTH
Active
Organization
HEALING HAVEN MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYADA MARIE WAGONER (CEO)
(650) 559-4850
Entity
Organization
Contact information
Practice address
1519 WASHINGTON AVE, SAN JACINTO, CA 92583-6075
(650) 559-4850
Mailing address
315 E ESPLANADE AVE UNIT 89, SAN JACINTO, CA 92583-5102
(951) 214-5071
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/22/2025
Last updated
04/27/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up