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Individual

STACEY CHARLENE MCVICKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OQP

Contact information

Practice address
500 CROWN POINT CIR STE 120, GRASS VALLEY, CA 95945-9561
(530) 265-7222
Mailing address
995 HELLING WAY, NEVADA CITY, CA 95959-8619
(530) 265-7222

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
372600000X
Adult Companion
Primary

Other

Enumeration date
10/29/2010
Last updated
09/05/2025
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