Chauntel Wiggins, MA | |
19375 California 116, Monte Rio, CA 95462 | |
(707) 865-1200 | |
Not Available |
Full Name | Chauntel Wiggins |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 19375 California 116, Monte Rio, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811244098 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
Mailing Address | Practice Location Address |
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Chauntel Wiggins, MA Po Box 519, Monte Rio, CA 95462-0519 Ph: (707) 865-1200 | Chauntel Wiggins, MA 19375 California 116, Monte Rio, CA 95462 Ph: (707) 865-1200 |
Ms. Mira Dhyana Wonderwheel, Counselor Medicare: Not Enrolled in Medicare Practice Location: 19375 Hwy 116, Monte Rio, CA 95462 Phone: 707-865-1200 | |
Dina Vineberg, Counselor Medicare: Not Enrolled in Medicare Practice Location: 22664 Sylvan Way, Monte Rio, CA 95462 Phone: 707-210-8445 | |
Ms. Denise Emily Horner, Counselor Medicare: Medicare Enrolled Practice Location: 19375 Highway 116, Monte Rio, CA 95462 Phone: 707-865-1200 Fax: 707-865-3151 | |
Alannah Judith Tomich, Counselor Medicare: Not Enrolled in Medicare Practice Location: 20025 El Rancho Way, Monte Rio, CA 95462 Phone: 865-789-5680 | |
Diana B Holloway, MFT Counselor Medicare: Medicare Enrolled Practice Location: 19375 Hwy 116, Monte Rio, CA 95462 Phone: 707-865-1200 | |
Lynn Marie Gordon, PH.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 19375 Highway 116, Monte Rio, CA 95462 Phone: 707-865-1200 Fax: 707-865-3151 |