Provider Demographics
NPI:1801074760
Name:HERSCH, MONICA TORRES (MFT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:TORRES
Last Name:HERSCH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PUTTER DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5002
Mailing Address - Country:US
Mailing Address - Phone:925-354-3597
Mailing Address - Fax:925-217-1143
Practice Address - Street 1:815 1ST ST
Practice Address - Street 2:2
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-1177
Practice Address - Country:US
Practice Address - Phone:925-354-3597
Practice Address - Fax:925-217-1143
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2008-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43116106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA389304OtherMANAGED HEALTH NETWORK