Provider Demographics
NPI:1740348309
Name:ASCANI, GERMAN FEDERICO (MD)
Entity type:Individual
Prefix:DR
First Name:GERMAN
Middle Name:FEDERICO
Last Name:ASCANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 GRAVENSTEIN HWY S STE 120
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-4863
Mailing Address - Country:US
Mailing Address - Phone:707-861-9208
Mailing Address - Fax:
Practice Address - Street 1:1020 GRAVENSTEIN HWY S STE 120
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4863
Practice Address - Country:US
Practice Address - Phone:707-861-9208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA892312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry