Provider Demographics
NPI:1093404964
Name:MAYSON, MONAH FRANCES
Entity Type:Individual
Prefix:
First Name:MONAH
Middle Name:FRANCES
Last Name:MAYSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8436 EDGECLIFF CT
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-0842
Mailing Address - Country:US
Mailing Address - Phone:916-647-1175
Mailing Address - Fax:
Practice Address - Street 1:8436 EDGECLIFF CT
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-0842
Practice Address - Country:US
Practice Address - Phone:916-647-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA711620163WP0200X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics