Individual provider · Type 1 NPI

Sofia Ekaterina Pettygrove

Mental Health Counselor · Modesto, CA

NPI number 1225548209 Active

Practice location

2020 Coffee Rd Ste A-5
Modesto, CA 95355-2427

Call (209) 338-7361 Map

Fax (209) 232-7093

Mailing address

PO Box 581921
Modesto, CA 95358-0033

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor 101YP2500XNone listed
Mental Health Counselor Primary 101YM0800X123864 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1225548209

Sofia Ekaterina Pettygrove's National Provider Identifier is 1225548209, issued on Oct 4, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Modesto, CA. The record was last updated on Aug 23, 2022.