Provider Demographics
NPI:1407535743
Name:TAPIA, MONSERRAT STEPHANIE (MHRS)
Entity Type:Individual
Prefix:MISS
First Name:MONSERRAT
Middle Name:STEPHANIE
Last Name:TAPIA
Suffix:
Gender:F
Credentials:MHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E PLEASANT VALLEY RD SPC 127
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-7668
Mailing Address - Country:US
Mailing Address - Phone:805-427-4580
Mailing Address - Fax:
Practice Address - Street 1:250 E PLEASANT VALLEY RD SPC 127
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-7668
Practice Address - Country:US
Practice Address - Phone:805-427-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CAMPSS-ILYUWR175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator