Sandra Isabel Viggiani, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1387 Issued in LA

Practice address

1 Lakeshore Dr Ste 1695
Lake Charles, LA 70629-0124

Phone

(337) 564-6405

Fax

(337) 656-2563

NPI assigned

Aug 24, 2010

Last updated

Mar 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in LA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellspring Psychological Services IncGroup PAC ID 2961763784, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellspring Psychological Services, Inc.

  • Counseling Psychologist
  • Monterey, CA
  • NPI 1336680495
  Medicare reassignment Care Compare group NPD
• Disney & Associates, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Charles, LA
  • NPI 1225183213
  Medicare reassignment NPD
• Counseling Services of Southwest Louisiana, Inc.

  • Mental Health Counselor
  • Lake Charles, LA
  • NPI 1831244821
  Medicare reassignment

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551398400000",
    "number": "1467768788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LAKESHORE DR STE 1695",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706290124",
            "telephone_number": "337-564-6405",
            "fax_number": "337-656-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LAKESHORE DR STE 1695",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706290124",
            "telephone_number": "337-564-6405",
            "fax_number": "337-656-2563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 Ernest St",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018406",
            "country_code": "US",
            "telephone_number": "818-486-3225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIGGIANI",
        "first_name": "SANDRA",
        "middle_name": "ISABEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2019-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "LA",
            "license": "1387",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "30290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerard M. Victoriano Jr., PA
• Victory Transportation (Victory Rentals & Transportation)
• Vidrine Pharmaceutical Group, LLC (Boudreaux's New Drug Store)
• Kimberly Ann Vidrine, M.S., CCC-SLP
• Pamela Kay Vidrine
• Shantel Viltz
• Hallie L. Vincent
• Hortensia Maria Vincent, LCSW
• Mishayla Vincent, LPN
• Myra S Vincent

• Clinical Psychologist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Clinical Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.