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General NPI Number Information
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NPI Number | 1427317445
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Entity Type | Individual
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Provider Name | MARIO HANKTON B.S
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Gender | Male
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 3050 BEACON BLVD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3467
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Country | US
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Telephone | 510-999-1869
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Fax | 510-530-8083
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Provider Business Mailing Address
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Address Line | 3050 BEACON BLVD
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-3467
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Country | US
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Telephone | 510-999-1869
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15955
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License Number State | CA
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