Provider Demographics
NPI:1255215760
Name:DIEKEN, MONA
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:DIEKEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 SAUL WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-4581
Mailing Address - Country:US
Mailing Address - Phone:916-993-0116
Mailing Address - Fax:
Practice Address - Street 1:333 UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6540
Practice Address - Country:US
Practice Address - Phone:916-931-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician