Provider Demographics
NPI:1528542859
Name:MONTEJANO, AARON
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:MONTEJANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E DUNHAM ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5455
Mailing Address - Country:US
Mailing Address - Phone:559-536-5528
Mailing Address - Fax:
Practice Address - Street 1:205 E DUNHAM ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5455
Practice Address - Country:US
Practice Address - Phone:559-536-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst