Provider Demographics
NPI:1184478851
Name:WILLIAMSON, MONIKEO TEK (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MONIKEO
Middle Name:TEK
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FAIRMOUNT AVE STE 323
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3155
Mailing Address - Country:US
Mailing Address - Phone:213-334-4111
Mailing Address - Fax:
Practice Address - Street 1:800 FAIRMOUNT AVE STE 323
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3155
Practice Address - Country:US
Practice Address - Phone:213-334-4111
Practice Address - Fax:213-335-5001
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029643363LF0000X
TX1157639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily