Provider Demographics
NPI:1942360110
Name:POXON, MONIKA LYNNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:LYNNE
Last Name:POXON
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:PO BOX 20023
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94620-0023
Mailing Address - Country:US
Mailing Address - Phone:510-251-3978
Mailing Address - Fax:510-251-3954
Practice Address - Street 1:969 BROADWAY
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4017
Practice Address - Country:US
Practice Address - Phone:510-251-3978
Practice Address - Fax:510-251-3954
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 18758103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical