Provider Demographics
NPI:1902355894
Name:MEJIA, MONICA GARCIA (MSN,RN,ANP-BC)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:GARCIA
Last Name:MEJIA
Suffix:
Gender:F
Credentials:MSN,RN,ANP-BC
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:GARCIA
Other - Last Name:MEJIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN-BC
Mailing Address - Street 1:14207 CUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-5219
Mailing Address - Country:US
Mailing Address - Phone:626-484-0366
Mailing Address - Fax:
Practice Address - Street 1:1605 S RIVERSIDE AVE # B
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-7707
Practice Address - Country:US
Practice Address - Phone:909-873-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95004865363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health