Provider Demographics
NPI:1417075524
Name:AMBRESTER, MONIQUE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:
Last Name:AMBRESTER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-2517
Mailing Address - Country:US
Mailing Address - Phone:818-893-5860
Mailing Address - Fax:
Practice Address - Street 1:1206 W 14TH ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-2517
Practice Address - Country:US
Practice Address - Phone:818-893-5860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48387106H00000X
CA52185106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist