Healthcare Provider Details

I. General information

NPI: 1013414564
Provider Name (Legal Business Name): JESSICA ALEXANDRA MONZON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2018
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLANNED PARENTHOOD 1045 N LAKE AVE
PASADENA CA
91104
US

IV. Provider business mailing address

1045 N LAKE AVE
PASADENA CA
91104-4521
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-0706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95008193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: