Healthcare Provider Details

I. General information

NPI: 1265253751
Provider Name (Legal Business Name): RENEE C MONCADA ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 E 6TH ST
BEAUMONT CA
92223-2146
US

IV. Provider business mailing address

136 E 6TH ST
BEAUMONT CA
92223-2146
US

V. Phone/Fax

Practice location:
  • Phone: 951-845-3588
  • Fax:
Mailing address:
  • Phone: 951-845-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number126790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: