Provider Demographics
NPI:1457630410
Name:MONTERO, DIANA F
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:F
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 1:1800 TULLY RD
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2946
Mailing Address - Country:US
Mailing Address - Phone:209-622-1420
Mailing Address - Fax:209-491-0627
Practice Address - Street 1:1800 TULLY RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2946
Practice Address - Country:US
Practice Address - Phone:209-622-1420
Practice Address - Fax:209-491-0627
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist