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KENNETH WISEMAN
NPI 1053905752
Counselor - Addiction (Substance Use Disorder) in Grass Valley, CA

Active since February 23, 2021
159 BRENTWOOD DR, GRASS VALLEY, CA 95945(530) 460-4083 Get Directions Write a Review

NPPES record last updated: May 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 7, 2025, Feb 25, 2025, Feb 23, 2021 (3 updates tracked since 2021).

About Kenneth Wiseman NPPES

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

KENNETH WISEMAN (NPI 1053905752) is an individual addiction (substance use disorder) provider in Grass Valley, California, licensed in California (B00003980425) and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1053905752
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameKENNETH WISEMAN
Location Address159 BRENTWOOD DRGrass Valley, CA 95945-5703
Mailing Address159 Brentwood DrGrass Valley, CA 95945-5703 · (530) 460-4083
Phone(530) 460-4083
Sole ProprietorNo
Enumeration DateFebruary 23, 2021
Last NPPES UpdateMay 7, 20253 updates tracked since enumeration
NPPES CertifiedMay 7, 2025
✔ NPI 1053905752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CA · B00003980425
159 BRENTWOOD DR, 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.

SAVANNAH M WALKER
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 271-1140
SAMANTHA E SMITH RADT
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 271-1140
SOFIA M DEGRUCCIO
Technician
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 273-1140
ANDREA FIGUEROA RADT
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 273-9541
PHILLIP KRULISKY RADT
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 878-5166
AMY JOHNSON
Counselor
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 271-1140
JESSICA ESCOBEDO
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 271-1140
SCOTT J DELLA MAGGIORA RADT
Counselor (Addiction (Substance Use Disorder))
159 BRENTWOOD DR
GRASS VALLEY, CA 95945
Nevada County (530) 273-1140

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 Kenneth Wiseman's NPI number?

The NPI number for Kenneth Wiseman is 1053905752. It was assigned to this individual provider in the NPPES registry on February 23, 2021.

Where is Kenneth Wiseman located?

Kenneth Wiseman practices at 159 Brentwood Dr, Grass Valley, CA 95945. The listed phone number is (530) 460-4083.

What is Kenneth Wiseman's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kenneth Wiseman was last updated on May 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.