1902355894 NPI number — MONICA GARCIA MEJIA MSN,RN,ANP-BC

Table of content: MONICA GARCIA MEJIA MSN,RN,ANP-BC (NPI 1902355894)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902355894 NPI number — MONICA GARCIA MEJIA MSN,RN,ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEJIA
Provider First Name:
MONICA
Provider Middle Name:
GARCIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSN,RN,ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEJIA
Provider Other First Name:
MONICA
Provider Other Middle Name:
GARCIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN-BC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1902355894
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14207 CUTLER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALDWIN PARK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91706-5219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-484-0366
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1605 S RIVERSIDE AVE # B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIALTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92376-7707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-873-5902
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  NP95004865 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)