Individual
MS. THERESA LEA HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
13192 BRUNSWICK RD, GRASS VALLEY, CA 95945-9388
(530) 273-0631
(530) 504-4328
Mailing address
13192 BRUNSWICK RD, GRASS VALLEY, CA 95945-9388
(530) 273-0631
(530) 504-4328
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C19661214
CA
175T00000X
Peer Specialist
Primary
MPSS-RJOFHE
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6906
CAARR
CA
Enumeration date
09/17/2009
Last updated
01/16/2025
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