Cheresa Wiggins, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

294494 Issued in CA

Practice address

12250 El Camino Real Ste 190
San Diego, CA 92130-2298

Phone

(858) 793-1460

NPI assigned

May 18, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1790132926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12250 EL CAMINO REAL STE 190",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302298",
            "telephone_number": "858-793-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12250 EL CAMINO REAL STE 190",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302298",
            "telephone_number": "858-793-1460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4401 Ford Ave",
            "address_2": "suite 301",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223021473",
            "country_code": "US",
            "telephone_number": "703-845-0500",
            "fax_number": "703-671-4626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "CHERESA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210203",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Seung Wietzke, NP
• Ghalia Wifak, RBT
• Wig USA Inc
• Kristen Michelle Wigby, M.D.
• Jacob Julian Wigdorski, IDC
• Dominique Wiggins
• Jennifer Marie Wiggins, LPC
• Kendrea R Wiggins
• Margaret Ellenora Wiggins
• Taylor Tierra Wiggins

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.