Provider Demographics
NPI:1689719130
Name:MONTOYA, SERINA MONIQUE
Entity Type:Individual
Prefix:MS
First Name:SERINA
Middle Name:MONIQUE
Last Name:MONTOYA
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 1:395 ZENOBIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-1068
Mailing Address - Country:US
Mailing Address - Phone:303-935-8697
Mailing Address - Fax:
Practice Address - Street 1:1810 S HOOKER
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80208-0001
Practice Address - Country:US
Practice Address - Phone:303-394-8105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator