Provider Demographics
NPI:1104081868
Name:PENA, MONICA LYN (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LYN
Last Name:PENA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LYN
Other - Last Name:BRANDTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2880 EATON RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-1805
Mailing Address - Country:US
Mailing Address - Phone:408-710-1907
Mailing Address - Fax:
Practice Address - Street 1:2880 EATON RD
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-1805
Practice Address - Country:US
Practice Address - Phone:408-710-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA83635101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health