MEDICARE: MARCELLO ANTONIO CATTANEO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1871323584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELLO ANTONIO CATTANEO

Provider Business Mailing Address
First Line	:	920 GRAND AVE
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-5506
Country	:	US
Telephone Number	:	415-376-2310
Fax Number	:

Provider Business Practice Location Address
First Line	:	920 GRAND AVE
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95404-5506
Country	:	US
Telephone Number	:	415-376-2310
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	10/22/2024

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Directions to “ MARCELLO ANTONIO CATTANEO ” Practice Location

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