Provider Demographics
NPI:1053784058
Name:MONICA, MARIA H (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:H
Last Name:MONICA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 WILDER ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2047
Mailing Address - Country:US
Mailing Address - Phone:805-418-7787
Mailing Address - Fax:
Practice Address - Street 1:706 LINDERO CANYON RD STE 776
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:CA
Practice Address - Zip Code:91377-5477
Practice Address - Country:US
Practice Address - Phone:818-991-1901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50344183500000X
NV14481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist