Provider Demographics
NPI:1457507113
Name:ROMERO, MONIQUE MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:MICHELLE
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:MICHELLE
Other - Last Name:PARAMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1512 E NEWCREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1218
Mailing Address - Country:US
Mailing Address - Phone:626-917-3842
Mailing Address - Fax:
Practice Address - Street 1:3125 N BROADWAY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-2703
Practice Address - Country:US
Practice Address - Phone:323-222-4591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA712981041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical