Provider Demographics
NPI:1497248348
Name:MONTEZ, MUNIRA (LCSW)
Entity Type:Individual
Prefix:
First Name:MUNIRA
Middle Name:
Last Name:MONTEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MUNIRA
Other - Middle Name:
Other - Last Name:FATEHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 22606
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390-2606
Mailing Address - Country:US
Mailing Address - Phone:818-667-1786
Mailing Address - Fax:
Practice Address - Street 1:4204 TRETORN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-2421
Practice Address - Country:US
Practice Address - Phone:818-667-1786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1019161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical