Provider Demographics
NPI:1083150577
Name:HIGGINS, SHALONDA MARIA
Entity Type:Individual
Prefix:
First Name:SHALONDA
Middle Name:MARIA
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14410 BAILEY CT STE 100
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-3205
Mailing Address - Country:US
Mailing Address - Phone:760-590-9026
Mailing Address - Fax:760-256-7280
Practice Address - Street 1:14410 BAILEY CT
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-3205
Practice Address - Country:US
Practice Address - Phone:760-590-9026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No101Y00000XBehavioral Health & Social Service ProvidersCounselor