Healthcare Provider Details

I. General information

NPI: 1952266470
Provider Name (Legal Business Name): MIKAYLA LYNN HIGGINS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 GOLD ST STE A
REDDING CA
96001-1937
US

IV. Provider business mailing address

718 JULY WAY APT A
REDDING CA
96003-1769
US

V. Phone/Fax

Practice location:
  • Phone: 530-337-5750
  • Fax:
Mailing address:
  • Phone: 530-917-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95037913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: