Individual provider Active NPI

Sofia M Degruccio

  • Technician
  • Grass Valley, CA
National Provider Identifier
1063012748
Registry record updated Jul 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
License
W5W5H3K5 Issued in CA
Practice address
159 Brentwood Dr
Grass Valley, CA 95945-5703
Phone
(530) 273-1140
NPI assigned
Oct 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X W5W5H3K5 CA Primary

Addresses

Primary practice location

159 Brentwood Dr
Grass Valley, CA 95945-5703

Mailing address

159 Brentwood Dr
Grass Valley, CA 95945-5703
Phone (530) 273-1140

Other practice location 1

145 Bost Ave
Nevada City, CA 95959-3249
Phone (530) 273-9541 ext. 470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R1382580420CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Granite Wellness Centers PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784332800000",
    "number": "1063012748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 BRENTWOOD DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455703",
            "telephone_number": "530-273-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 BRENTWOOD DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455703",
            "telephone_number": "530-273-1140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Bost Ave",
            "address_purpose": "LOCATION",
            "city": "Nevada City",
            "state": "CA",
            "postal_code": "959593249",
            "country_code": "US",
            "telephone_number": "530-273-9541 x470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEGRUCCIO",
        "first_name": "SOFIA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-30",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "CA",
            "license": "W5W5H3K5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.