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NPI Code Detail

MEDICARE: BERENICE MONJE

MEDICARE: BERENICE MONJE
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
1390200000XStudent in an Organized Health Care Education/Training Program
2225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1619494556
Entity Type Code : Individual
Provider Name (Legal Business Name) : BERENICE MONJE
Provider Business Mailing Address
First Line : 1555 PARKMOOR AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2407
Country : US
Telephone Number : 408-282-0401
Fax Number :
Provider Business Practice Location Address
First Line : 1555 PARKMOOR AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95128-2407
Country : US
Telephone Number : 408-282-0401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 05/20/2025

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