Provider Demographics
NPI:1316675424
Name:DELYSER, MONIKA ZOFIA (PMHNP)
Entity type:Individual
Prefix:MISS
First Name:MONIKA
Middle Name:ZOFIA
Last Name:DELYSER
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 OCEAN ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2898
Mailing Address - Country:US
Mailing Address - Phone:408-896-0894
Mailing Address - Fax:
Practice Address - Street 1:1111 OCEAN ST UNIT 204
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2898
Practice Address - Country:US
Practice Address - Phone:408-896-0894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-08
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA610277163W00000X, 163WP0807X, 163WP0808X
CA95033153363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA9096323OtherDRIVER LICENSE