Healthcare Provider Details

I. General information

NPI: 1578557062
Provider Name (Legal Business Name): LOUIS MONACO PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 WILSHIRE BLVD #600
BEVERLY HILLS CA
90210-5530
US

IV. Provider business mailing address

9171 WILSHIRE BLVD #600
BEVERLY HILLS CA
90210-5530
US

V. Phone/Fax

Practice location:
  • Phone: 310-666-7952
  • Fax:
Mailing address:
  • Phone: 310-666-7952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number16252
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number16252
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 21425
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number16252
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number16252
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY 21425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: