1376813980 NPI number — DR. SHERYL MONAUGHAN PHD, A PSYCHOLOGICAL CORPORATION

Table of content: (NPI 1376813980)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376813980 NPI number — DR. SHERYL MONAUGHAN PHD, A PSYCHOLOGICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. SHERYL MONAUGHAN PHD, A PSYCHOLOGICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376813980
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10736 JEFFERSON BLVD
Provider Second Line Business Mailing Address:
505
Provider Business Mailing Address City Name:
CULVER CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90230-4933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-313-0999
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10940 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
600
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90024-3915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-313-0999
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MONAUGHAN
Authorized Official First Name:
SHERYL
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-313-0999

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1437453701 . This is a "NPI" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com