Individual
AMY WIEDERHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3175 SUNSET BLVD, ROCKLIN, CA 95677-3091
(916) 645-3300
Mailing address
3175 SUNSET BLVD, ROCKLIN, CA 95677-3091
(916) 645-3300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
373H00000X
Day Training/Habilitation Specialist
—
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Enumeration date
01/15/2025
Last updated
03/05/2026
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