Provider Demographics
NPI:1477562320
Name:POLITANO, MONICA MARIA (MS)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:MARIA
Last Name:POLITANO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3331 POWER INN RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3889
Mailing Address - Country:US
Mailing Address - Phone:916-875-9890
Mailing Address - Fax:916-875-1190
Practice Address - Street 1:3331 POWER INN RD
Practice Address - Street 2:STE 180
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3889
Practice Address - Country:US
Practice Address - Phone:916-875-9890
Practice Address - Fax:916-875-1190
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC53634106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1477562320OtherSACRAMENTO COUNTY