Provider Demographics
NPI:1902005309
Name:JOSIE C MONTGOMERY MFT
Entity Type:Organization
Organization Name:JOSIE C MONTGOMERY MFT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:661-951-1700
Mailing Address - Street 1:43923 15TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4758
Mailing Address - Country:US
Mailing Address - Phone:661-951-1700
Mailing Address - Fax:661-951-1790
Practice Address - Street 1:43923 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4758
Practice Address - Country:US
Practice Address - Phone:661-951-1700
Practice Address - Fax:661-951-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT14166106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty