Kendrea R Wiggins

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Practice address

1963 4TH Ave
San Diego, CA 92101-2394

Phone

(619) 233-3432

NPI assigned

Jan 16, 2022

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1689792533
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700
  NPD (past)

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

{
    "created_epoch": "1642291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1841941333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 EMERALD AVE APT P",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205014",
            "telephone_number": "619-301-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1963 4TH AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012394",
            "telephone_number": "619-233-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "KENDREA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-16",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Michelle Wigby, M.D.
• Jacob Julian Wigdorski, IDC
• Cheresa Wiggins, DPT
• Dominique Wiggins
• Jennifer Marie Wiggins, LPC
• Margaret Ellenora Wiggins
• Taylor Tierra Wiggins
• Traci Wiggins
• Nancy Elizabeth Wight, M.D.
• Kristina Sciarrillo Wightkin, LMFT

• State or Local Public Health Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• State or Local Public Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2022; 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.