Provider Demographics
NPI:1518323500
Name:VIESCAS, MONICA MONIQUE
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MONIQUE
Last Name:VIESCAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10113 FERN ST
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91733-2009
Mailing Address - Country:US
Mailing Address - Phone:323-702-2029
Mailing Address - Fax:
Practice Address - Street 1:10113 FERN STREET
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91733
Practice Address - Country:US
Practice Address - Phone:323-702-2029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator