Provider Demographics
NPI:1376659474
Name:JOSEPH MICHEL MONTES PHD A PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:JOSEPH MICHEL MONTES PHD A PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-449-6725
Mailing Address - Street 1:595 E COLORADO BL
Mailing Address - Street 2:#615
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101
Mailing Address - Country:US
Mailing Address - Phone:626-449-6725
Mailing Address - Fax:626-449-4820
Practice Address - Street 1:595 E COLORADO BL
Practice Address - Street 2:#615
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101
Practice Address - Country:US
Practice Address - Phone:626-449-6725
Practice Address - Fax:626-449-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7770103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7770Medicare PIN