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General NPI Number Information
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NPI Number | 1679721609
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Entity Type | Individual
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Provider Name | KENDRA LYN WIGGINS
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 11/26/2014
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Provider Practice Location Address
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Address Line | 915 N MILPAS ST 2ND FLOOR
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2331
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Country | US
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Telephone | 805-617-7858
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Fax | 805-963-8880
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Provider Business Mailing Address
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Address Line | 915 N MILPAS ST 2ND FLOOR
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City | SANTA BARBARA
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State | CA
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Zip | 93103-2331
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Country | US
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Telephone | 805-617-7858
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Fax | 805-963-8880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A126601
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ML60020183
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License Number State | WA
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