Healthcare Provider Details

I. General information

NPI: 1740191345
Provider Name (Legal Business Name): ROBERT JOSEPH MONN MA, AMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MISSION ST # 208
SAN MARINO CA
91108-1632
US

IV. Provider business mailing address

2018 MILAN AVE
SOUTH PASADENA CA
91030-4637
US

V. Phone/Fax

Practice location:
  • Phone: 323-860-8782
  • Fax:
Mailing address:
  • Phone: 646-259-3297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT152906
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: