Provider Demographics
NPI:1225208473
Name:MONGE, NORA EDELMIRA (CPHW)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:EDELMIRA
Last Name:MONGE
Suffix:
Gender:F
Credentials:CPHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-3505
Mailing Address - Country:US
Mailing Address - Phone:714-973-9218
Mailing Address - Fax:714-973-9269
Practice Address - Street 1:2223 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-3505
Practice Address - Country:US
Practice Address - Phone:714-973-9218
Practice Address - Fax:714-973-9269
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator