Provider Demographics
NPI:1710538202
Name:SANO, MATTHEW YORK
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:YORK
Last Name:SANO
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 1:57 ALTA MESA CIR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4601
Mailing Address - Country:US
Mailing Address - Phone:916-335-0675
Mailing Address - Fax:
Practice Address - Street 1:505 E ROMIE LN
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4031
Practice Address - Country:US
Practice Address - Phone:866-311-4617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician