Healthcare Provider Details

I. General information

NPI: 1427317445
Provider Name (Legal Business Name): MARIO HANKTON B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MARIO HANKTON APCC, MHRS

II. Dates (important events)

Enumeration Date: 05/10/2012
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 BEACON BLVD
WEST SACRAMENTO CA
95691-3467
US

IV. Provider business mailing address

3050 BEACON BLVD
WEST SACRAMENTO CA
95691-3467
US

V. Phone/Fax

Practice location:
  • Phone: 510-999-1869
  • Fax: 510-530-8083
Mailing address:
  • Phone: 510-999-1869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15955
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: