Healthcare Provider Details

I. General information

NPI: 1942957303
Provider Name (Legal Business Name): NICHOLAS MONZON M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-3204
US

IV. Provider business mailing address

17938 BALFERN AVE
BELLFLOWER CA
90706-7112
US

V. Phone/Fax

Practice location:
  • Phone: 310-271-2275
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: