Provider Demographics
NPI:1760848782
Name:MONTY, LESLIE ANNE
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANNE
Last Name:MONTY
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 1:1021 4TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:TAFT
Mailing Address - State:CA
Mailing Address - Zip Code:93268-2433
Mailing Address - Country:US
Mailing Address - Phone:661-765-7025
Mailing Address - Fax:661-765-7045
Practice Address - Street 1:1021 4TH ST STE B
Practice Address - Street 2:
Practice Address - City:TAFT
Practice Address - State:CA
Practice Address - Zip Code:93268-2433
Practice Address - Country:US
Practice Address - Phone:661-868-6601
Practice Address - Fax:661-868-6666
Is Sole Proprietor?:No
Enumeration Date:2016-01-06
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1023121041C0700X
CAASW843231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical