Provider Demographics
NPI:1407183247
Name:REDJA, MONA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONA
Middle Name:
Last Name:REDJA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SANSOME ST STE 3500
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-4436
Mailing Address - Country:US
Mailing Address - Phone:949-280-4554
Mailing Address - Fax:
Practice Address - Street 1:1 SANSOME ST STE 3500
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-4436
Practice Address - Country:US
Practice Address - Phone:949-280-4554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27995103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical