Provider Demographics
NPI:1043416688
Name:MONTES, YVONNE
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:MONTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 WALL ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90011-3952
Mailing Address - Country:US
Mailing Address - Phone:323-233-3216
Mailing Address - Fax:
Practice Address - Street 1:460 E CARSON PLAZA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90746-3228
Practice Address - Country:US
Practice Address - Phone:310-856-5799
Practice Address - Fax:310-856-5798
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190501AN101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor