Provider Demographics
NPI:1770643173
Name:MONTGOMERY, SHARON MANNESMANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MANNESMANN
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:201 CENTRE PLAZA DR
Mailing Address - Street 2:JUVENILE COURT MENTAL HEALTH, DEPT. 425
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-2142
Mailing Address - Country:US
Mailing Address - Phone:323-526-6386
Mailing Address - Fax:323-260-5298
Practice Address - Street 1:201 CENTRE PLAZA DR
Practice Address - Street 2:JUVENILE COURT MENTAL HEALTH, DEPT. 425
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-2142
Practice Address - Country:US
Practice Address - Phone:323-526-6386
Practice Address - Fax:323-260-5298
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CALCS124001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical