MEDICARE: MONIQUE MICHELLE MONDRAGON

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	101YS0200X	School Counselor	260056262	CA

General Provider Information

NPI Number	:	1912853797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE MICHELLE MONDRAGON

Provider Business Mailing Address
First Line	:	9501 LEMON AVE
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-1305
Country	:	US
Telephone Number	:	626-548-5167
Fax Number	:

Provider Business Practice Location Address
First Line	:	9501 LEMON AVE
Second Line	:
City	:	TEMPLE CITY
State	:	CA
Zip	:	91780-1305
Country	:	US
Telephone Number	:	626-548-5167
Fax Number	:

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

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ MONIQUE MICHELLE MONDRAGON ” Practice Location

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