Healthcare Provider Details

I. General information

NPI: 1063952083
Provider Name (Legal Business Name): MS. MONICA WESTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 S GRAND AVE STE 600
LOS ANGELES CA
90015
US

IV. Provider business mailing address

10742 LANDALE ST
NORTH HOLLYWOOD CA
91602-2303
US

V. Phone/Fax

Practice location:
  • Phone: 213-742-6250
  • Fax:
Mailing address:
  • Phone: 818-209-4490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT98331
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberIMF98331
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: