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Individual

SOFIA M DEGRUCCIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 273-1140
Mailing address
159 BRENTWOOD DR, GRASS VALLEY, CA 95945-5703
(530) 273-1140

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1382580420
CA
374700000X
Technician
Primary
W5W5H3K5
CA

Other

Enumeration date
10/30/2020
Last updated
07/18/2026
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