Provider Demographics
NPI:1376899328
Name:GARTY, MONICA M (APRN)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:M
Last Name:GARTY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 GROSVENOR BLVD APT 216
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-7310
Mailing Address - Country:US
Mailing Address - Phone:805-402-1639
Mailing Address - Fax:
Practice Address - Street 1:5550 GROSVENOR BLVD APT 216
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-7310
Practice Address - Country:US
Practice Address - Phone:805-402-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5046363LP0200X
CA22063363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics