Provider Demographics
NPI:1710161443
Name:MONTES, MARCELA (NP)
Entity Type:Individual
Prefix:PROF
First Name:MARCELA
Middle Name:
Last Name:MONTES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1907
Mailing Address - Country:US
Mailing Address - Phone:626-915-7674
Mailing Address - Fax:626-966-1952
Practice Address - Street 1:211 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1907
Practice Address - Country:US
Practice Address - Phone:626-919-7674
Practice Address - Fax:626-966-1952
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA15621363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily