Provider Demographics
NPI:1588902258
Name:DAWLEY, MONICA TAN (FNP-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:TAN
Last Name:DAWLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:TAN
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2880 STORY RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-3942
Mailing Address - Country:US
Mailing Address - Phone:408-729-9700
Mailing Address - Fax:
Practice Address - Street 1:2880 STORY RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-3942
Practice Address - Country:US
Practice Address - Phone:408-729-9700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18007363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily