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General NPI Number Information
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NPI Number | 1780616201
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Entity Type | Individual
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Provider Name | MONIKA FERREIRA QUEIROZ DO VALLE D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/01/2022
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Provider Practice Location Address
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Address Line | 268 CHANNING WAY
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2606
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Country | US
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Telephone | 415-322-8834
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Fax |
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Provider Business Mailing Address
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Address Line | 268 CHANNING WAY
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2606
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Country | US
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Telephone | 415-322-8834
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A11322
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 228415
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | DOS-2271-0
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License Number State | HI
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