Provider Demographics
NPI:1356481444
Name:ROMERO, MONICA Y
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:Y
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:Y
Other - Last Name:NARANJO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1351
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:NM
Mailing Address - Zip Code:87567-1351
Mailing Address - Country:US
Mailing Address - Phone:505-927-1663
Mailing Address - Fax:
Practice Address - Street 1:4309 CLOUD DANCE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-2591
Practice Address - Country:US
Practice Address - Phone:505-438-2960
Practice Address - Fax:505-438-2960
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-0392225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant