Provider Demographics
NPI:1861716490
Name:PECK, MONICA (MSW, LCSW#26360)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:PECK
Suffix:
Gender:F
Credentials:MSW, LCSW#26360
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:EURTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW,#26
Mailing Address - Street 1:3838 SAN DIMAS ST
Mailing Address - Street 2:STE A100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2286
Mailing Address - Country:US
Mailing Address - Phone:661-377-2250
Mailing Address - Fax:661-327-5432
Practice Address - Street 1:3838 SAN DIMAS ST
Practice Address - Street 2:STE A100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2286
Practice Address - Country:US
Practice Address - Phone:661-377-2250
Practice Address - Fax:661-327-5432
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW263601041C0700X
CA263601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861716490OtherNPI