Provider Demographics
NPI:1437990678
Name:MONSADA, CHRISTOPHER TRABALLO
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:TRABALLO
Last Name:MONSADA
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 1:4101 INNOVATOR DR APT 1504
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3858
Mailing Address - Country:US
Mailing Address - Phone:916-747-6399
Mailing Address - Fax:
Practice Address - Street 1:4101 INNOVATOR DR APT 1504
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3858
Practice Address - Country:US
Practice Address - Phone:916-747-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268573164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse