Healthcare Provider Details

I. General information

NPI: 1528536802
Provider Name (Legal Business Name): MRS. STACY SCALES MONAGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1272 HAYES ST
NAPA CA
94559-1711
US

IV. Provider business mailing address

PO BOX 3417
NAPA CA
94558-0341
US

V. Phone/Fax

Practice location:
  • Phone: 707-346-5192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123324
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: