Provider Demographics
NPI:1972376366
Name:VASQUEZ, MONIZA BEL DE VERA (NP-C)
Entity Type:Individual
Prefix:MS
First Name:MONIZA BEL
Middle Name:DE VERA
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21121 COHASSET ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1401
Mailing Address - Country:US
Mailing Address - Phone:818-491-6397
Mailing Address - Fax:
Practice Address - Street 1:5015 EAGLE ROCK BLVD STE 210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2085
Practice Address - Country:US
Practice Address - Phone:747-300-7541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95025805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily