Provider Demographics
NPI:1871723668
Name:MONCADA, JANEL MARIE (MA)
Entity type:Individual
Prefix:MS
First Name:JANEL
Middle Name:MARIE
Last Name:MONCADA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:JANEL
Other - Middle Name:MONCADA
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:622 VAQUERO RD
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-3748
Mailing Address - Country:US
Mailing Address - Phone:626-802-8137
Mailing Address - Fax:
Practice Address - Street 1:10416 LOWER AZUSA RD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-1208
Practice Address - Country:US
Practice Address - Phone:626-652-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner