Healthcare Provider Details

I. General information

NPI: 1083904023
Provider Name (Legal Business Name): NINA E HIGGINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARIA LN STE 300
WALNUT CREEK CA
94596-5314
US

IV. Provider business mailing address

9212 BLUEWOOD LN NE
ALBUQUERQUE NM
87122-1038
US

V. Phone/Fax

Practice location:
  • Phone: 650-275-3939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number340771
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD14982
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC207801
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD2017-0648
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: