Healthcare Provider Details

I. General information

NPI: 1639092588
Provider Name (Legal Business Name): GRACIA LAUREN SIKES WELLNESS COACH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SCHOOL ST
POINT ARENA CA
95468
US

IV. Provider business mailing address

PO BOX 1064
POINT ARENA CA
95468-1064
US

V. Phone/Fax

Practice location:
  • Phone: 707-882-2131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number403489A001
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: