Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Wagner

Individual provider Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1154759033

Nicole Wagner is an Emotionally Disturbed Childrens' Residential Treatment Facility in Grass Valley, California. Practices as a sole proprietor. Registered with an NPI since 2013.

In the registry since
2013
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Practice location Address checks out

714 W Main St
Grass Valley, CA 95945
Phone: (530) 477-9800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X

Record details

NPI number1154759033
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 31, 2013
Last updated in NPPESOctober 31, 2013
Mailing address714 W. Main St, Grass Valley, CA 95945

Other providers in Grass Valley