Healthcare Provider Details

I. General information

NPI: 1629761051
Provider Name (Legal Business Name): MONIQUE V SANTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONIQUE SANTY

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 N FAIR OAKS AVE
PASADENA CA
91103-3050
US

IV. Provider business mailing address

2010 BATSON AVE APT 290
ROWLAND HEIGHTS CA
91748-3525
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-6793
  • Fax:
Mailing address:
  • Phone: 626-353-0512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: