Provider Demographics
NPI:1215253638
Name:GARCIA-WIGGEN, GRACE C (RN, MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:C
Last Name:GARCIA-WIGGEN
Suffix:
Gender:F
Credentials:RN, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6060 SUNRISE VISTA DR
Mailing Address - Street 2:SUITE 2000E
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-7053
Mailing Address - Country:US
Mailing Address - Phone:916-969-8975
Mailing Address - Fax:916-209-9653
Practice Address - Street 1:6060 SUNRISE VISTA DR
Practice Address - Street 2:SUITE 2000E
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-7053
Practice Address - Country:US
Practice Address - Phone:916-969-8975
Practice Address - Fax:916-209-9653
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS259511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical