Wildermuth, Jaycie

Wildermuth, Jaycie is an individual health care provider with primary practice located at 4250 Fowler Ln Ste 204 , Diamond Springs CA 95619-9782. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is her primary health care specialty. Wildermuth, Jaycie can be contacted via phone (530) 295-1491.

Contact Information

Primary practice address
4250 Fowler Ln Ste 204 Diamond Springs CA 95619-9782
Phone: (530) 295-1491
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Professional 101YP2500X 14738 California
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 141816 California

Profile Details

NPI number 1215665427
LBN Legal business name Wildermuth, Jaycie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2022
Last updated Feb 1st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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