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NPI Code Detail

MEDICARE: DR. RICHARD A. MANCINA M.D.

MEDICARE: DR. RICHARD A. MANCINA M.D.
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
12084P0800XPsychiatry PhysicianG54270CA
22084P0804XChild & Adolescent Psychiatry PhysicianG54270CA

General Provider Information

NPI Number : 1376565523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD A. MANCINA M.D.
Provider Business Mailing Address
First Line : 5777 MADISON AVE STE 240
Second Line :
City : SACRAMENTO
State : CA
Zip : 95841-3308
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8912 VOLUNTEER LN
Second Line :
City : SACRAMENTO
State : CA
Zip : 95826-3221
Country : US
Telephone Number : 916-344-0199
Fax Number : 906-339-3029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 12/23/2021

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