Provider Demographics
NPI:1376670208
Name:MONTERO, NINOSKA
Entity Type:Individual
Prefix:
First Name:NINOSKA
Middle Name:
Last Name:MONTERO
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:PO BOX 92885
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-2885
Mailing Address - Country:US
Mailing Address - Phone:626-463-1422
Mailing Address - Fax:626-463-1422
Practice Address - Street 1:3827 E COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3935
Practice Address - Country:US
Practice Address - Phone:626-463-1422
Practice Address - Fax:626-463-1422
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health