Provider Demographics
NPI:1760783138
Name:MONETATHCHI, JUDITH LYNN (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:LYNN
Last Name:MONETATHCHI
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69601 CIMARRON COURT RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-4926
Mailing Address - Country:US
Mailing Address - Phone:760-770-0427
Mailing Address - Fax:
Practice Address - Street 1:490 S FARRELL DR
Practice Address - Street 2:SUITE C 208
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7992
Practice Address - Country:US
Practice Address - Phone:760-325-4088
Practice Address - Fax:760-778-3781
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 64814106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist