Healthcare Provider Details

I. General information

NPI: 1205755287
Provider Name (Legal Business Name): SIERRA MENTAL WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD STE 200
SALINAS CA
93906-3127
US

IV. Provider business mailing address

925 HIGHLAND POINTE DR STE 130
ROSEVILLE CA
95678-5426
US

V. Phone/Fax

Practice location:
  • Phone: 831-204-7411
  • Fax:
Mailing address:
  • Phone: 916-783-5207
  • Fax: 916-783-9145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NICOLE VANNEMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 916-783-5207