Provider Demographics
NPI:1235705369
Name:MONTES DE OCA, ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:MONTES DE OCA
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 1:35325 DATE PALM DR STE 151C
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7002
Mailing Address - Country:US
Mailing Address - Phone:442-307-3395
Mailing Address - Fax:760-610-0397
Practice Address - Street 1:35325 DATE PALM DR STE 151C
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7002
Practice Address - Country:US
Practice Address - Phone:442-307-3395
Practice Address - Fax:760-610-0397
Is Sole Proprietor?:No
Enumeration Date:2021-05-30
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW832121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical