Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Derek Widener, PTA

Physical Therapy Assistant in Santa Rosa, CA · enumerated 2011.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1154691624

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Registry record

Entity type Individual (Type 1)

Name Derek Widener

Credential PTA

Sex Male

Practice address 1221 N Dutton Ave, Santa Rosa, CA, 95401

Phone (707) 543-8360

Enumeration date Dec 30, 2011

Last updated in NPPES Dec 30, 2011

Taxonomy & licenses

225200000X Physical Therapy Assistant Respiratory, Developmental, Rehabilitative and Restorative Service Providers · License 6568 (CA) Primary

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Derek Widener?

The National Provider Identifier (NPI) for Derek Widener is 1154691624, a Type 1 (individual) record in the CMS NPPES registry.

Where does Derek Widener practice?

The practice location on file with NPPES is in Santa Rosa, CA. Providers can have multiple locations; NPPES lists the primary practice address.

Other providers at this practice address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-12-30.