Provider Demographics
NPI:1508401530
Name:MASSEI, TYTUS
Entity Type:Individual
Prefix:
First Name:TYTUS
Middle Name:
Last Name:MASSEI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 H ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-1216
Mailing Address - Country:US
Mailing Address - Phone:916-874-8994
Mailing Address - Fax:916-874-7106
Practice Address - Street 1:700 H ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-1216
Practice Address - Country:US
Practice Address - Phone:916-874-8994
Practice Address - Fax:916-874-7106
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker