1164531810 NPI number — MS. MONICA LANDABURU GILL-CALLAHAN MA

Table of content: MS. MONICA LANDABURU GILL-CALLAHAN MA (NPI 1164531810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164531810 NPI number — MS. MONICA LANDABURU GILL-CALLAHAN MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILL-CALLAHAN
Provider First Name:
MONICA
Provider Middle Name:
LANDABURU
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GILL-CALLAHAN
Provider Other First Name:
MONIQUE
Provider Other Middle Name:
LANDABURU
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1164531810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10480 CANADEO CIRCLE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELK GROVE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-714-8025
Provider Business Mailing Address Fax Number:
916-282-1940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4875 BROADWAY
Provider Second Line Business Practice Location Address:
STE 125
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-874-2512
Provider Business Practice Location Address Fax Number:
916-875-1190
Provider Enumeration Date:
08/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC43697 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com