MEDICARE: MONIQUE MERCEDES REEVES LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LCSW90786	CA

General Provider Information

NPI Number	:	1992420731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE MERCEDES REEVES LCSW

Provider Business Mailing Address
First Line	:	1535 N BROADWAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-2099
Country	:	US
Telephone Number	:	760-291-4005
Fax Number	:	760-739-7313

Provider Business Practice Location Address
First Line	:	1535 N BROADWAY
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92026-2099
Country	:	US
Telephone Number	:	760-291-4005
Fax Number	:	760-739-7313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2022
Last Update Date	:	05/08/2026

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