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General NPI Number Information
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NPI Number | 1689391369
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Entity Type | Individual
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Provider Name | MONIQUE S OVERSTREET ASW, MSW
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Gender | Female
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 32080 DEL CIELO OESTE
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City | BONSALL
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State | CA
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Zip | 92003-3807
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Country | US
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Telephone | 225-384-1483
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Fax |
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Provider Business Mailing Address
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Address Line | 32080 DEL CIELO OESTE
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City | BONSALL
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State | CA
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Zip | 92003-3807
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Country | US
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Telephone | 225-384-1483
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 101504
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 117627
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License Number State | CA
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