Brianna Caitlin Widman, MHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

840 N Avenue 66
Los Angeles, CA 90042-1508

Phone

(626) 395-7100

NPI assigned

Oct 8, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1245837509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W WALNUT ST STE 375",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911240001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N AVENUE 66",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900421508",
            "telephone_number": "626-395-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 S Farrell Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922627992",
            "country_code": "US",
            "telephone_number": "626-517-2442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "BRIANNA",
        "middle_name": "CAITLIN",
        "credential": "MHW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-08",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thilini Wickramarachchi
• Nell Cathryn Wickstrom, AMFT
• Azzah Widatalla, DDS
• Jared Robert Widder, D.O.
• Stacey Lind Widger
• Hailey Kate Widman
• Colette Widrin, LAC
• Jonathan Patrick Wiebe, M.D.
• Jessica Wiechec, PSY.D.
• Martina H Wiedau, MD

• Community Health Worker in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.