Provider Demographics
NPI:1730469727
Name:MONSERRATT, LORENA HUERTA (MA)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:HUERTA
Last Name:MONSERRATT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:
Other - Last Name:HUERTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10801 NATIONAL BLVD.
Mailing Address - Street 2:SUITE 611
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-4170
Mailing Address - Country:US
Mailing Address - Phone:310-273-4843
Mailing Address - Fax:310-273-5056
Practice Address - Street 1:10801 NATIONAL BLVD.
Practice Address - Street 2:SUITE 611
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-4170
Practice Address - Country:US
Practice Address - Phone:310-273-4843
Practice Address - Fax:310-273-5056
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist