Provider Demographics
NPI:1568204873
Name:ANGARA, MONIQUE SHAUNTA
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:SHAUNTA
Last Name:ANGARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:SHAUNTA
Other - Last Name:ANGARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:612 WHITBY LN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5063
Mailing Address - Country:US
Mailing Address - Phone:925-759-4736
Mailing Address - Fax:
Practice Address - Street 1:3200 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2819
Practice Address - Country:US
Practice Address - Phone:925-229-1985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program