Most Relevant Information
Provider Data
| NPI Number: | 1003667296 |
| Provider Name: | MENDY KAY DEGENNARO B00003290224 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | B00003290224 |
Most Important Dates
| Enumeration Date: | 03/27/2024 |
| Last Updated: | 03/27/2024 |
Provider Practice Location
3647 40TH ST
SACRAMENTO
CA
958173609
Practice Location Phone/Fax
| Phone: | 9164521068 |
| Fax: | 9164699415 |
Provider Mailing Location
3647 40TH ST
SACRAMENTO
CA
958173609
Provider Mailing Phone/Fax
| Phone: | 9164521068 |
| Fax: | 9164521068 |