Provider Demographics
NPI:1164046223
Name:ILDEBRANDO MONTE, MARIA CAROLINA
Entity Type:Individual
Prefix:
First Name:MARIA CAROLINA
Middle Name:
Last Name:ILDEBRANDO MONTE
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 1:3052 MERIDIAN CT
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5624
Mailing Address - Country:US
Mailing Address - Phone:916-298-9071
Mailing Address - Fax:
Practice Address - Street 1:3052 MERIDIAN CT
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5624
Practice Address - Country:US
Practice Address - Phone:916-298-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician