Active NPI
Brenda Judith Monge
- Marriage & Family Therapist
- Los Angeles, CA
National Provider Identifier
1548042278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 143576
- Practice address
- 1530 S Olive St
Los Angeles, CA 90015-3023 - Phone
- (213) 747-5542
- NPI assigned
- Oct 17, 2023
- Reactivated
- Nov 9, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 143576 | CA | Primary |
Addresses
Primary practice location
1530 S Olive St
Los Angeles, CA 90015-3023
Mailing address
PO Box 371112
Reseda, CA 91337-1112
Phone (818) 903-5811
Other practice location 1
16360 Roscoe Blvd Fl 2
Van Nuys, CA 91406-1219
Phone (818) 901-4830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 143576 | CA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1548042278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 371112",
"city": "RESEDA",
"state": "CA",
"postal_code": "913371112",
"telephone_number": "818-903-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 S OLIVE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900153023",
"telephone_number": "213-747-5542"
}
],
"practiceLocations": [
{
"address_1": "16360 Roscoe Blvd Fl 2",
"address_purpose": "LOCATION",
"city": "Van Nuys",
"state": "CA",
"postal_code": "914061219",
"country_code": "US",
"telephone_number": "818-901-4830",
"fax_number": "818-373-4830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MONGE",
"first_name": "BRENDA",
"middle_name": "JUDITH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-17",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"deactivation_date": "2023-10-31",
"reactivation_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "143576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.