Provider Demographics
NPI:1689920563
Name:KIMANI, MONICA (LPT)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:
Last Name:KIMANI
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MS
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:KIMANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPT
Mailing Address - Street 1:1856 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-3796
Mailing Address - Country:US
Mailing Address - Phone:714-746-6554
Mailing Address - Fax:951-722-4615
Practice Address - Street 1:850 E FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-5230
Practice Address - Country:US
Practice Address - Phone:909-421-9482
Practice Address - Fax:909-421-9494
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician