Provider Demographics
NPI:1114057320
Name:MONTES, BRENDA DALIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:DALIA
Last Name:MONTES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 CORPORATE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-2639
Mailing Address - Country:US
Mailing Address - Phone:909-802-1364
Mailing Address - Fax:
Practice Address - Street 1:801 CORPORATE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91768-2639
Practice Address - Country:US
Practice Address - Phone:909-802-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA680261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical