Healthcare Provider Details

I. General information

NPI: 1093610149
Provider Name (Legal Business Name): MRS. SOPHYIA CARRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 W CENTER ST STE 6
YREKA CA
96097-2900
US

IV. Provider business mailing address

PO BOX 494100
REDDING CA
96049-4100
US

V. Phone/Fax

Practice location:
  • Phone: 530-841-7190
  • Fax: 530-841-7194
Mailing address:
  • Phone: 530-245-5805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: