Provider Demographics
NPI:1083281075
Name:MONTANO, KARLA ANGELA REYES (NP)
Entity Type:Individual
Prefix:
First Name:KARLA ANGELA
Middle Name:REYES
Last Name:MONTANO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10984 HARDY PECAN CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-6882
Mailing Address - Country:US
Mailing Address - Phone:909-560-7433
Mailing Address - Fax:
Practice Address - Street 1:10984 HARDY PECAN CT
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-6882
Practice Address - Country:US
Practice Address - Phone:909-560-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95017434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily