Individual
LACEY LEE PETERNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 CROWN POINT CIR STE 100, GRASS VALLEY, CA 95945-9561
(530) 273-5440
Mailing address
13556 TRANQUILITY LN, NEVADA CITY, CA 95959-9670
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
07/30/2025
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