Provider Demographics
NPI:1376128520
Name:MONTES, ANNALICIA D (RBT)
Entity Type:Individual
Prefix:
First Name:ANNALICIA
Middle Name:D
Last Name:MONTES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5558 CALIFORNIA AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0706
Mailing Address - Country:US
Mailing Address - Phone:714-616-5827
Mailing Address - Fax:
Practice Address - Street 1:6500 WHITE LN APT 7
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7771
Practice Address - Country:US
Practice Address - Phone:714-616-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician