Stacey Lind Widger

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

156445 Issued in CA

Practice address

13323 W Washington Blvd
Los Angeles, CA 90066-5170

Phone

(323) 301-3407

NPI assigned

May 3, 2024

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1714694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1982451142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13101 W WASHINGTON BLVD STE 134",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900668122",
            "telephone_number": "310-306-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13323 W WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900665170",
            "telephone_number": "323-301-3407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDGER",
        "first_name": "STACEY",
        "middle_name": "LIND",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-03",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "156445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Anette Wickman, M.D.
• Thilini Wickramarachchi
• Nell Cathryn Wickstrom, AMFT
• Azzah Widatalla, DDS
• Jared Robert Widder, D.O.
• Brianna Caitlin Widman, MHW
• Hailey Kate Widman
• Colette Widrin, LAC
• Jonathan Patrick Wiebe, M.D.
• Jessica Wiechec, PSY.D.

• Marriage & Family Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.