Provider Demographics
NPI:1902082803
Name:DEMAS, MONICA BEZZI (LMFT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:BEZZI
Last Name:DEMAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 W 9TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3158
Mailing Address - Country:US
Mailing Address - Phone:310-938-4575
Mailing Address - Fax:
Practice Address - Street 1:624 W 9TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3158
Practice Address - Country:US
Practice Address - Phone:310-938-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CALMFT77371106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)