Provider Demographics
NPI:1598440257
Name:LYONS, MONIQUE SIMONE (MA, MFT)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:SIMONE
Last Name:LYONS
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:MS
Other - First Name:KIKI
Other - Middle Name:
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:240 GRAND AVE APT 36
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4573
Mailing Address - Country:US
Mailing Address - Phone:415-802-9630
Mailing Address - Fax:
Practice Address - Street 1:240 GRAND AVE APT 36
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4573
Practice Address - Country:US
Practice Address - Phone:415-802-9630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist