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NPI Code Detail

MEDICARE: JOELY WIGGINS

MEDICARE: JOELY WIGGINS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor158720CA

General Provider Information

NPI Number : 1598378010
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOELY WIGGINS
Provider Business Mailing Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number :
Provider Business Practice Location Address
First Line : 1816 PORTOFINO DR
Second Line :
City : OCEANSIDE
State : CA
Zip : 92054-6130
Country : US
Telephone Number : 760-433-6361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2020
Last Update Date : 02/13/2026

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Directions to “ JOELY WIGGINS ” Practice Location

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