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MICHAELA LAKE
NPI 1033451364
Residential Treatment Facility, Emotionally Disturbed Children in Grass Valley, CA

Active since March 25, 2013
714 W MAIN ST, GRASS VALLEY, CA 95945(530) 477-9800(530) 477-9803 Get Directions Write a Review

NPPES record last updated: March 25, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Michaela Lake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAELA LAKE (NPI 1033451364) is an individual residential treatment facility, emotionally disturbed children provider in Grass Valley, California and active in the NPI registry since March 2013.

NPPES Registry Identity

NPI1033451364
Entity TypeIndividualFemale
Primary Taxonomy322D00000X
Provider Legal NameMICHAELA LAKE
Location Address714 W MAIN STGrass Valley, CA 95945-6410
Mailing Address714 W Main StGrass Valley, CA 95945-6410 · (530) 477-9800 · Fax (530) 477-9803
Phone(530) 477-9800
Fax(530) 477-9803
Sole ProprietorYes
Enumeration DateMarch 25, 2013
✔ NPI 1033451364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities
Taxonomy Code322D00000X
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
714 W MAIN ST, Grass Valley, CA 95945
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTOPHER SALTER
Residential Treatment Facility, Emotionally Disturbed Children
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
PAUL GRICE
Residential Treatment Facility, Emotionally Disturbed Children
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
CYNTHIA L PETTIJOHN
Residential Treatment Facility, Emotionally Disturbed Children
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
BRYAN LASSEGARD
Counselor
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
ROBERT ALEXANDER ONTIVEROS
Counselor
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
JENNIFER ANN MACDONELL
Marriage & Family Therapist
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
NORMA P SAENZ
Residential Treatment Facility, Emotionally Disturbed Children
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800
SABRIYA ADEL MUIR
Counselor
714 W MAIN ST
GRASS VALLEY, CA 95945
Nevada County (530) 477-9800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michaela Lake's NPI number?

The NPI number for Michaela Lake is 1033451364. It was assigned to this individual provider in the NPPES registry on March 25, 2013.

Where is Michaela Lake located?

Michaela Lake practices at 714 W Main St, Grass Valley, CA 95945. The listed phone number is (530) 477-9800.

What is Michaela Lake's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Michaela Lake was last updated on March 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.