Provider Demographics
NPI:1003504622
Name:JUAREZ, MONICA E (MS COUNSELING)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:E
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:MS COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6934 CREBS AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4023
Mailing Address - Country:US
Mailing Address - Phone:818-219-0547
Mailing Address - Fax:
Practice Address - Street 1:5255 ETIWANDA AVE.
Practice Address - Street 2:SUITE 212
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-201-9741
Practice Address - Fax:818-708-5455
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty