Provider Demographics
NPI:1366864126
Name:STONG, MONT (AUD)
Entity Type:Individual
Prefix:
First Name:MONT
Middle Name:
Last Name:STONG
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 COLLINGWOOD ST
Mailing Address - Street 2:APT 201
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1997
Mailing Address - Country:US
Mailing Address - Phone:415-404-0065
Mailing Address - Fax:
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:RM 934
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3997
Practice Address - Country:US
Practice Address - Phone:415-362-2901
Practice Address - Fax:415-362-2429
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADAU1201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist