Provider Demographics
NPI:1457242596
Name:BURGOS, MONICA (CH)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:BURGOS
Suffix:
Gender:F
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 E FRONTAGE RD # 81
Mailing Address - Street 2:
Mailing Address - City:TUMACACORI
Mailing Address - State:AZ
Mailing Address - Zip Code:85640-9997
Mailing Address - Country:US
Mailing Address - Phone:602-697-1134
Mailing Address - Fax:
Practice Address - Street 1:1006 LOMBARD WAY
Practice Address - Street 2:
Practice Address - City:TUBAC
Practice Address - State:AZ
Practice Address - Zip Code:85646
Practice Address - Country:US
Practice Address - Phone:602-697-1134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker