Active NPI
Traci Wiggins
- Pharmacist
- San Diego, CA
National Provider Identifier
1447422852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 36437
- Practice address
- 4405 Vandever Ave
San Diego, CA 92120-3315 - Phone
- (619) 516-7625
- NPI assigned
- Mar 25, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 36437 | CA | Primary |
Addresses
Primary practice location
4405 Vandever Ave
San Diego, CA 92120-3315
Mailing address
13522 Calais Dr
Del Mar, CA 92014-3526
Phone (858) 350-3401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36437 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206403200000",
"number": "1447422852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13522 CALAIS DR",
"city": "DEL MAR",
"state": "CA",
"postal_code": "920143526",
"telephone_number": "858-350-3401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 VANDEVER AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921203315",
"telephone_number": "619-516-7625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGGINS",
"first_name": "TRACI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-25",
"last_updated": "2008-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "36437",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.