Provider Demographics
NPI:1275261943
Name:MONTALBANO, SABELLA
Entity Type:Individual
Prefix:
First Name:SABELLA
Middle Name:
Last Name:MONTALBANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8859 WHITE PEACOCK WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-3714
Mailing Address - Country:US
Mailing Address - Phone:916-224-8723
Mailing Address - Fax:
Practice Address - Street 1:8859 WHITE PEACOCK WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-3714
Practice Address - Country:US
Practice Address - Phone:916-224-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY8881282106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician