Provider Demographics
NPI:1871323584
Name:CATTANEO, MARCELLO ANTONIO
Entity type:Individual
Prefix:
First Name:MARCELLO
Middle Name:ANTONIO
Last Name:CATTANEO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-5506
Mailing Address - Country:US
Mailing Address - Phone:415-376-2310
Mailing Address - Fax:
Practice Address - Street 1:920 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-5506
Practice Address - Country:US
Practice Address - Phone:415-376-2310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician