Provider Demographics
NPI:1801039060
Name:BARBOSA, MONICA ESTELA
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:ESTELA
Last Name:BARBOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N ORANGE GROVE BLVD
Mailing Address - Street 2:207
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3333
Mailing Address - Country:US
Mailing Address - Phone:626-796-3453
Mailing Address - Fax:626-744-3411
Practice Address - Street 1:855 N ORANGE GROVE BLVD
Practice Address - Street 2:207
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-3333
Practice Address - Country:US
Practice Address - Phone:626-796-3453
Practice Address - Fax:626-744-3411
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner