Provider Demographics
NPI:1568684520
Name:MONTY, CYNTHIA JANINE (RN, PNP, PHN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JANINE
Last Name:MONTY
Suffix:
Gender:F
Credentials:RN, PNP, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 GREENVALE
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-5529
Mailing Address - Country:US
Mailing Address - Phone:949-888-4777
Mailing Address - Fax:
Practice Address - Street 1:9802 WOODBURY AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92844-2819
Practice Address - Country:US
Practice Address - Phone:714-663-6411
Practice Address - Fax:714-663-6470
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA376410163WP0200X
CA8815363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics