Provider Demographics
NPI:1598396848
Name:FRISBY, MONIQUE SHAUNTE (DNP, PMHNP)
Entity Type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:SHAUNTE
Last Name:FRISBY
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7745 BOULDER AVE UNIT 423
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-8023
Mailing Address - Country:US
Mailing Address - Phone:909-770-2191
Mailing Address - Fax:
Practice Address - Street 1:29289 JASMINE PL
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-3969
Practice Address - Country:US
Practice Address - Phone:909-770-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-27
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013721363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health