MEDICARE: MONIQUE AMY PRITCHARD CADC-I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		CA
2	172V00000X	Community Health Worker		CA
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	CI39220623	CA

General Provider Information

NPI Number	:	1588237432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE AMY PRITCHARD CADC-I

Provider Business Mailing Address
First Line	:	1340 TULLY RD STE 304
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-3055
Country	:	US
Telephone Number	:	408-271-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 TULLY RD STE 304
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95122-3055
Country	:	US
Telephone Number	:	408-271-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	05/20/2026

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