Healthcare Provider Details

I. General information

NPI: 1053722983
Provider Name (Legal Business Name): MARCIA MALLORCA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCIA UNGER M.D.

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4625 44TH ST
SACRAMENTO CA
95820-3909
US

IV. Provider business mailing address

PO BOX 580371
ELK GROVE CA
95758-0007
US

V. Phone/Fax

Practice location:
  • Phone: 916-244-5800
  • Fax:
Mailing address:
  • Phone: 916-216-8508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA141379
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA141379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: