Provider Demographics
NPI:1922351493
Name:MONTARA, CHASE (RN)
Entity Type:Individual
Prefix:MS
First Name:CHASE
Middle Name:
Last Name:MONTARA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:NOYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 1915
Mailing Address - Street 2:
Mailing Address - City:EL GRANADA
Mailing Address - State:CA
Mailing Address - Zip Code:94018-1915
Mailing Address - Country:US
Mailing Address - Phone:650-533-4385
Mailing Address - Fax:
Practice Address - Street 1:802 BREWSTER AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1510
Practice Address - Country:US
Practice Address - Phone:650-363-4111
Practice Address - Fax:650-364-6927
Is Sole Proprietor?:No
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422944163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse