MEDICARE: DAPHNE NELL COSTANTINO

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	103TP2701X	Group Psychotherapy Psychologist

General Provider Information

NPI Number	:	1619834835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAPHNE NELL COSTANTINO

Provider Business Mailing Address
First Line	:	2426 7TH AVE STE 2
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95818-3912
Country	:	US
Telephone Number	:	408-835-6474
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 7TH AVE STE 2
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95818-3912
Country	:	US
Telephone Number	:	408-835-6474
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “ DAPHNE NELL COSTANTINO ” Practice Location

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