Provider Demographics
NPI:1679316616
Name:VILCONE, EFFIE MAY (MA)
Entity type:Individual
Prefix:MRS
First Name:EFFIE
Middle Name:MAY
Last Name:VILCONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:EFFIE
Other - Middle Name:MAY
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 MYRTLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1219
Mailing Address - Country:US
Mailing Address - Phone:707-445-7000
Mailing Address - Fax:707-445-7143
Practice Address - Street 1:901 MYRTLE AVENUE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1219
Practice Address - Country:US
Practice Address - Phone:707-445-7000
Practice Address - Fax:707-445-7143
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool