Healthcare Provider Details

I. General information

NPI: 1497950489
Provider Name (Legal Business Name): MONICA PALMA NP-C, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N MOUNTAIN AVE STE A104
UPLAND CA
91786-4359
US

IV. Provider business mailing address

600 N MOUNTAIN AVE STE A104
UPLAND CA
91786-4359
US

V. Phone/Fax

Practice location:
  • Phone: 909-581-4667
  • Fax: 909-581-4455
Mailing address:
  • Phone: 909-581-4667
  • Fax: 909-581-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP1700X
TaxonomyPerinatal Nurse Practitioner
License NumberRNP 548298
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRNP548298
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberRNP 548298
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number236365
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number13363
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: