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General NPI Number Information
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NPI Number | 1831947175
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Entity Type | Organization
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Legal Business Name | SIERRA MENTAL WELLNESS GROUP
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Dates
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Enumeration Date | 05/10/2024
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Last Update Date | 05/10/2024
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Provider Practice Location Address
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Address Line | 1515 FOXRIDGE CIR
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City | AUBURN
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State | CA
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Zip | 95603-5958
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Country | US
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Telephone | 530-305-4416
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Fax |
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Provider Business Mailing Address
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Address Line | 1515 FOXRIDGE CIR
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City | AUBURN
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State | CA
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Zip | 95603-5958
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Country | US
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Telephone | 530-305-4416
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Fax |
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Authorized Official
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Title or Position | CRISIS CLINICIAN
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Name | CASSIDY M NODER
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Credential | MA
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Telephone | 530-305-4416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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