Healthcare Provider Details

I. General information

NPI: 1174442560
Provider Name (Legal Business Name): MONICA IMPERIAL KO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14124 BUCHER AVE
SYLMAR CA
91342-1424
US

IV. Provider business mailing address

4706 NEW YORK AVE
LA CRESCENTA CA
91214-1840
US

V. Phone/Fax

Practice location:
  • Phone: 661-713-6037
  • Fax:
Mailing address:
  • Phone: 818-279-3128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: