Healthcare Provider Details

I. General information

NPI: 1043299373
Provider Name (Legal Business Name): ALISA DIGGS-GOODING PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3324 E RAY RD UNIT 1057
HIGLEY AZ
85236-4550
US

IV. Provider business mailing address

3324 E RAY RD UNIT 1057
HIGLEY AZ
85236-4550
US

V. Phone/Fax

Practice location:
  • Phone: 602-620-6659
  • Fax:
Mailing address:
  • Phone: 602-620-6659
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1864
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: