Provider Demographics
NPI:1700061629
Name:GERMEK, GENORA MARY
Entity Type:Individual
Prefix:MS
First Name:GENORA
Middle Name:MARY
Last Name:GERMEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GENORA
Other - Middle Name:MARY
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8903 SALMON FALLS DR APT D
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-1966
Mailing Address - Country:US
Mailing Address - Phone:916-323-4282
Mailing Address - Fax:
Practice Address - Street 1:444 N 3RD ST STE 230
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-0227
Practice Address - Country:US
Practice Address - Phone:916-264-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)