Provider Demographics
NPI:1497569313
Name:MONAH NUNEZ, PHYLLIS ANDREA
Entity type:Individual
Prefix:MRS
First Name:PHYLLIS ANDREA
Middle Name:
Last Name:MONAH NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:MONAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:405 LYNBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-1760
Mailing Address - Country:US
Mailing Address - Phone:415-810-6305
Mailing Address - Fax:
Practice Address - Street 1:405 LYNBROOK DR
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-1760
Practice Address - Country:US
Practice Address - Phone:415-810-6305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW973251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical