Healthcare Provider Details

I. General information

NPI: 1154121838
Provider Name (Legal Business Name): MONIQUE COOMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13521 EDWARDS ST
WESTMINSTER CA
92683-2502
US

IV. Provider business mailing address

13521 EDWARDS ST
WESTMINSTER CA
92683-2502
US

V. Phone/Fax

Practice location:
  • Phone: 714-895-7764
  • Fax:
Mailing address:
  • Phone: 714-895-7764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: