Provider Demographics
NPI:1053722983
Name:MALLORCA, MARCIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:
Last Name:MALLORCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARCIA
Other - Middle Name:
Other - Last Name:UNGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 580371
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0007
Mailing Address - Country:US
Mailing Address - Phone:916-216-8508
Mailing Address - Fax:
Practice Address - Street 1:4625 44TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-3909
Practice Address - Country:US
Practice Address - Phone:916-244-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1413792084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry