Provider Demographics
NPI:1023849528
Name:MONROY, ANANGELICA
Entity type:Individual
Prefix:
First Name:ANANGELICA
Middle Name:
Last Name:MONROY
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 1:3816 SAN JUAN ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-4225
Mailing Address - Country:US
Mailing Address - Phone:510-866-6810
Mailing Address - Fax:
Practice Address - Street 1:1070 CONCORD AVE STE 105
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-5608
Practice Address - Country:US
Practice Address - Phone:925-849-5349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program