Provider Demographics
NPI:1689786097
Name:MONTEMAYOR, CATHY F (MFT)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:F
Last Name:MONTEMAYOR
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E SANTA CLARA ST
Mailing Address - Street 2:SUITE 15
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-5972
Mailing Address - Country:US
Mailing Address - Phone:805-653-7335
Mailing Address - Fax:805-653-7335
Practice Address - Street 1:701 E SANTA CLARA ST
Practice Address - Street 2:SUITE 15
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-5972
Practice Address - Country:US
Practice Address - Phone:805-653-7335
Practice Address - Fax:805-653-7335
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC33970106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT339700OtherBLUE SHIELD OF CALIFORNIA