Provider Demographics
NPI:1508139650
Name:MINTON, MONA SHAH (IMF)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:SHAH
Last Name:MINTON
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 W VERMONT AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-6584
Mailing Address - Country:US
Mailing Address - Phone:760-432-9884
Mailing Address - Fax:760-432-9953
Practice Address - Street 1:474 W VERMONT AVE STE 104
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6584
Practice Address - Country:US
Practice Address - Phone:760-432-9884
Practice Address - Fax:760-432-9953
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist