Provider Demographics
NPI:1184723603
Name:STRICKLAND, MONIQUE ANTIONETTE
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:ANTIONETTE
Last Name:STRICKLAND
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 1:415 E AVE I LANCASTER CA 93535
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93552-3319
Mailing Address - Country:US
Mailing Address - Phone:661-522-6770
Mailing Address - Fax:
Practice Address - Street 1:415 E AVE I LANCASTER CA 93535
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93552-3319
Practice Address - Country:US
Practice Address - Phone:661-522-6770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95020672363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health