NPI 1033451364

Michaela Lake

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Grass Valley, CA

Practice location

Address: 714 W Main St, Grass Valley, CA 95945-6410
Phone: (530) 477-9800
Fax: (530) 477-9803

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in California →

Registry record

NPI: 1033451364
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Mar 2013
Record last updated: 25 Mar 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.