Organization
LAURA WILCOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HEGGARTY (DIRECTOR OF BEHAVIORAL HEALTH)
(530) 265-1437
Entity
Organization
Contact information
Practice address
500 CROWN POINT CIR, SUITE 120, GRASS VALLEY, CA 95945-9514
(530) 265-1437
Mailing address
500 CROWN POINT CIR, SUITE 120, GRASS VALLEY, CA 95945-9514
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
08/22/2020
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