Basic Information
Provider Information
NPI: 1003932252
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MONAGHAN
FirstName: PAULA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
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Mailing Information
Address1: 393 E WALNUT ST
Address2: 3RD FLOOR PHR SYSTEMS
City: PASADENA
State: CA
PostalCode: 911880001
CountryCode: US
TelephoneNumber: 6264053640
FaxNumber: 6264056768
Practice Location
Address1: 5601 DE SOTO AVE
Address2:  
City: WOODLAND HILLS
State: CA
PostalCode: 913676701
CountryCode: US
TelephoneNumber: 8187192000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/21/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XCNM132CAY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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