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NICOLE WAGNER
NPI 1154759033
Residential Treatment Facility, Emotionally Disturbed Children in Grass Valley, CA

Active since October 31, 2013
714 W MAIN ST, GRASS VALLEY, CA 95945(530) 477-9800 Get Directions Write a Review

NPPES record last updated: October 31, 2013. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Nicole Wagner NPPES

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

NICOLE WAGNER (NPI 1154759033) is an individual residential treatment facility, emotionally disturbed children provider in Grass Valley, California and active in the NPI registry since October 2013.

NPPES Registry Identity

NPI1154759033
Entity TypeIndividualFemale
Primary Taxonomy322D00000X
Provider Legal NameNICOLE WAGNER
Location Address714 W MAIN STGrass Valley, CA 95945
Mailing Address714 W. Main StGrass Valley, CA 95945 · (530) 477-9800 · Fax (530) 477-9803
Phone(530) 477-9800
Sole ProprietorYes
Enumeration DateOctober 31, 2013
✔ NPI 1154759033 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 Nicole Wagner's NPI number?

The NPI number for Nicole Wagner is 1154759033. It was assigned to this individual provider in the NPPES registry on October 31, 2013.

Where is Nicole Wagner located?

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

What is Nicole Wagner'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 Nicole Wagner was last updated on October 31, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.