Provider Demographics
NPI:1568158962
Name:SENG, MONIREATH
Entity Type:Individual
Prefix:
First Name:MONIREATH
Middle Name:
Last Name:SENG
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 1:2501 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2708
Mailing Address - Country:US
Mailing Address - Phone:562-424-6105
Mailing Address - Fax:562-427-1678
Practice Address - Street 1:2501 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2708
Practice Address - Country:US
Practice Address - Phone:562-424-6105
Practice Address - Fax:562-427-1678
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)