Provider Demographics
NPI:1932831948
Name:GIANNOTTI, MONICA L (CMT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:L
Last Name:GIANNOTTI
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5845 E DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6214
Mailing Address - Country:US
Mailing Address - Phone:559-304-3310
Mailing Address - Fax:
Practice Address - Street 1:5845 E DWIGHT WAY
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-6214
Practice Address - Country:US
Practice Address - Phone:559-304-3310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90544225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty