Provider Demographics
NPI:1255197315
Name:CACY-MCFARLAND, MONO (LPT)
Entity type:Individual
Prefix:MRS
First Name:MONO
Middle Name:
Last Name:CACY-MCFARLAND
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MRS
Other - First Name:MONO
Other - Middle Name:
Other - Last Name:NHEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT
Mailing Address - Street 1:144 JACK LONDON DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95409-3549
Mailing Address - Country:US
Mailing Address - Phone:209-670-5525
Mailing Address - Fax:
Practice Address - Street 1:339 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-5117
Practice Address - Country:US
Practice Address - Phone:707-568-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37739167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician