Provider Demographics
NPI:1316687866
Name:BERNAL, MONICA MARIE (DO)
Entity type:Individual
Prefix:MISS
First Name:MONICA
Middle Name:MARIE
Last Name:BERNAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:MONICA
Other - Middle Name:MARIE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:29375 SPENCER DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1416
Mailing Address - Country:US
Mailing Address - Phone:213-703-7629
Mailing Address - Fax:
Practice Address - Street 1:147 N BRENT ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2854
Practice Address - Country:US
Practice Address - Phone:805-652-5011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program