Provider Demographics
NPI:1427317445
Name:HANKTON, MARIO (BS)
Entity type:Individual
Prefix:MR
First Name:MARIO
Middle Name:
Last Name:HANKTON
Suffix:
Gender:
Credentials:BS
Other - Prefix:
Other - First Name:MARIO
Other - Middle Name:
Other - Last Name:HANKTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APCC, MHRS
Mailing Address - Street 1:3050 BEACON BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-3467
Mailing Address - Country:US
Mailing Address - Phone:510-999-1869
Mailing Address - Fax:
Practice Address - Street 1:3050 BEACON BLVD
Practice Address - Street 2:
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-3467
Practice Address - Country:US
Practice Address - Phone:510-999-1869
Practice Address - Fax:510-530-8083
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15955101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health