Provider Demographics
NPI:1760411094
Name:MONROE, SONI KIM (PSYD)
Entity Type:Individual
Prefix:
First Name:SONI
Middle Name:KIM
Last Name:MONROE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 AIRPORT DR
Mailing Address - Street 2:SUITE 135
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6140
Mailing Address - Country:US
Mailing Address - Phone:424-201-1600
Mailing Address - Fax:424-201-1601
Practice Address - Street 1:2601 AIRPORT DR
Practice Address - Street 2:SUITE 135
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6140
Practice Address - Country:US
Practice Address - Phone:424-201-1600
Practice Address - Fax:424-201-1601
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY16701103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical