Provider Demographics
NPI:1063914547
Name:HARDING, MONIQUE JACQUELINE
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:JACQUELINE
Last Name:HARDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11286 1/2 SAN MATEO DR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3226
Mailing Address - Country:US
Mailing Address - Phone:786-624-8030
Mailing Address - Fax:
Practice Address - Street 1:11286 1/2 SAN MATEO DR
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3226
Practice Address - Country:US
Practice Address - Phone:786-624-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician