Basic Information
| Provider Information | |||||||||
| NPI: | 1508005596 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MONROE | ||||||||
| FirstName: | ARYAN | ||||||||
| MiddleName: | PAULETTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 W SANTA ANA BLVD STE 801 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927014134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147045900 | ||||||||
| FaxNumber: | 7149783419 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 W SANTA ANA BLVD STE 801 | ||||||||
| Address2: | |||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927014134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7147045900 | ||||||||
| FaxNumber: | 7149783419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2009 | ||||||||
| LastUpdateDate: | 03/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 87228 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.