Donnell Wigfall, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

20A11625 Issued in CA

Practice address

12625 Hesperia Rd
Victorville, CA 92395-7720

Phone

(760) 995-8300

Fax

(760) 955-2356

NPI assigned

Apr 23, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1841465556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 HARVARD AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113819",
            "telephone_number": "909-762-6625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12625 HESPERIA RD",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957720",
            "telephone_number": "760-995-8300",
            "fax_number": "760-955-2356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "San Antonio Family Center",
            "address_2": "2629 Clarendon Ave.",
            "address_purpose": "LOCATION",
            "city": "Huntington Park",
            "state": "CA",
            "postal_code": "90255",
            "country_code": "US",
            "telephone_number": "323-584-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGFALL",
        "first_name": "DONNELL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "20A11625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jamie Delamotte White
• Delissa White
• Vanessa Lee Whitford
• Lisa Whittingslow-Alonzo
• Whole Holistic Care
• Erin Shiloh Wikert, LMFT
• Katherine Christine Wilcox, MD
• Wildwood Court LLC
• Lashalle Wiley
• Amy Louise Wilkin, A.T.,C.

• Child & Adolescent Psychiatry Physician in Victorville, CA
• Providers in Victorville, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.