Provider Demographics
NPI:1215135124
Name:ORDONE, MONIQUE TONYA
Entity type:Individual
Prefix:
First Name:MONIQUE
Middle Name:TONYA
Last Name:ORDONE
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 1:515 SARAH PL
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-7750
Mailing Address - Country:US
Mailing Address - Phone:408-832-0270
Mailing Address - Fax:
Practice Address - Street 1:39159 PASEO PADRE PKWY STE 121
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1600
Practice Address - Country:US
Practice Address - Phone:510-952-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53974106H00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program