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General NPI Number Information
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NPI Number | 1710403985
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Entity Type | Individual
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Provider Name | JESSICA NICOLE MONIZ
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Gender | Female
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 2702 CLAYTON RD. 100
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City | CONCORD
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State | CA
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Zip | 94519-9451
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Country | US
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Telephone | 925-222-3775
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Fax | 818-562-0914
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Provider Business Mailing Address
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Address Line | 1045 E MEADOW AVE
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City | PINOLE
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State | CA
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Zip | 94564-2618
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Country | US
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Telephone | 510-332-0988
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF83693
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License Number State | CA
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