Provider Demographics
NPI:1023342219
Name:BOCANEGRA, MONICA ELIZABETH (PHD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:ELIZABETH
Last Name:BOCANEGRA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2712
Mailing Address - Country:US
Mailing Address - Phone:305-310-8259
Mailing Address - Fax:302-239-5531
Practice Address - Street 1:710 YORKLYN RD
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8747
Practice Address - Country:US
Practice Address - Phone:302-239-5255
Practice Address - Fax:302-239-5531
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0000825103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical