Provider Demographics
NPI:1700180866
Name:CONE, MATHIAS XAVIER
Entity Type:Individual
Prefix:MR
First Name:MATHIAS
Middle Name:XAVIER
Last Name:CONE
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 1:13562 SALINAS ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:CA
Mailing Address - Zip Code:95329-9458
Mailing Address - Country:US
Mailing Address - Phone:775-770-0403
Mailing Address - Fax:
Practice Address - Street 1:28 HANOVER LN STE B
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7267
Practice Address - Country:US
Practice Address - Phone:530-487-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2021-11-28
Deactivation Date:2021-06-08
Deactivation Code:
Reactivation Date:2021-11-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst