Healthcare Provider Details

I. General information

NPI: 1619381670
Provider Name (Legal Business Name): ANA MONSEGUE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3772 TIBBETTS ST PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST
RIVERSIDE CA
92506-2605
US

IV. Provider business mailing address

3772 TIBBETTS ST PLANNED PARENTHOOD OF THE PACIFIC SOUTHWEST
RIVERSIDE CA
92506-2605
US

V. Phone/Fax

Practice location:
  • Phone: 888-743-7526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number2066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: