Provider Demographics
NPI:1619590742
Name:RAGHEB, MONIKA MAGDY
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:MAGDY
Last Name:RAGHEB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONIKA
Other - Middle Name:MAGDY
Other - Last Name:RAGHEB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MONIKA RGAHEB, MA,
Mailing Address - Street 1:14077 LEMOLI AVE # 94
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-8852
Mailing Address - Country:US
Mailing Address - Phone:310-848-8256
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4599
Practice Address - Country:US
Practice Address - Phone:714-834-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107908106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist