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General NPI Number Information
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NPI Number | 1700205499
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Entity Type | Individual
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Provider Name | CARA WIGGINS
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Gender | Female
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Dates
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Enumeration Date | 04/10/2014
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 39400 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2310
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Country | US
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Telephone | 510-248-5053
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Fax |
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Provider Business Mailing Address
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Address Line | 231 MARKET PL STE 634
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City | SAN RAMON
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State | CA
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Zip | 94583-4743
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Country | US
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Telephone | 510-813-1545
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 103034
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License Number State | CA
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