Healthcare Provider Details

I. General information

NPI: 1821236274
Provider Name (Legal Business Name): STEPHANIE ANN WIGGINS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 01/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 OAK ST
SAN FRANCISCO CA
94117-2217
US

IV. Provider business mailing address

245 11TH ST
SAN FRANCISCO CA
94103-3732
US

V. Phone/Fax

Practice location:
  • Phone: 415-431-8252
  • Fax: 415-431-3195
Mailing address:
  • Phone: 415-431-8252
  • Fax: 415-431-3195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number0000000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: