Provider Demographics
NPI:1508077454
Name:WALTERS, MONICA GORRINDO (MSW)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:GORRINDO
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:LEA
Other - Last Name:GORRINDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3010 LEEWARD WAY
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-2415
Mailing Address - Country:US
Mailing Address - Phone:805-985-6962
Mailing Address - Fax:
Practice Address - Street 1:250.W CITRUS GROVE AVE
Practice Address - Street 2:STE 150
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-983-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS82741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical