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General NPI Number Information
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NPI Number | 1710174552
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Entity Type | Individual
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Provider Name | MONICA JEANNE PAPPAPETRU
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Gender | Female
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 9707 MAGNOLIA AVE
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City | RIVERSIDE
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State | CA
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Zip | 92503
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Country | US
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Telephone | 951-345-9321
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | LAKE ELISNORE
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State | CA
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Zip | 92531-5724
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Country | US
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Telephone | 951-345-9321
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 43362
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | 43362
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | 43362
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 43362
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License Number State | CA
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