Basic Information
| Provider Information | |||||||||
| NPI: | 1942471313 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUGAN-STANFIELD | ||||||||
| FirstName: | MONIQUE | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3270 CASHILL BLVD | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895095017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758439767 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 605 SIERRA ROSE DR | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895112359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756895410 | ||||||||
| FaxNumber: | 7756895431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2008 | ||||||||
| LastUpdateDate: | 03/01/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PY0538 | NV | Y | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | PY0538 | 01 | NV | STATE LICENSE | OTHER |