Monique Rochelle Acosta, NP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Marina del Rey, CA
NPI 1487425872 · NPPES record last updated Jan 15, 2024
Key facts
- NPI
- 1487425872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 95028617 (CA)
- Practice address
- 4750 Lincoln Blvd Apt 457
Marina del Rey, CA 90292-9306 - Phone
- (323) 877-3115
- NPI assigned
- Jan 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240411002406 | CA | Practitioner - Nurse Practitioner | 5597104406 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95028617 | CA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ehab Yacoub MD Inc. | Current |
Accepting new patients | |
| Neuro Wellness Spa, a Medical PC | Past | Accepting new patients |
Locations
1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113
17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 95028617 | CA | Yes |
Addresses
Primary practice location
4750 Lincoln Blvd Apt 457
Marina del Rey, CA 90292-9306
Mailing address
4750 Lincoln Blvd Apt 457
Marina del Rey, CA 90292-9306
Phone (323) 877-3115
Other providers in Marina del Rey, CA
- A. Buckins D.D.S., Inc.
- Samar Abbasher
- Sandy Abdou
- Anna Grayce Abel
- Shahram Shawn Abrishamy
- Acupuncture Westside Inc
- Prabidhi Adhikari
- Admiralty Surgery Center, Inc
- Advance Dermatology & Laser Medical Center Inc.
- Shirin Aghazadeh
All providers in Marina del Rey, CA · Psychiatric/Mental Health Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.