Provider Demographics
NPI:1265196703
Name:MONTES, JESSICA CELENE (MSNA, CRNA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:CELENE
Last Name:MONTES
Suffix:
Gender:F
Credentials:MSNA, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 HOGEE DR
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-7139
Mailing Address - Country:US
Mailing Address - Phone:562-618-5710
Mailing Address - Fax:
Practice Address - Street 1:7120 HOGEE DR
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-7139
Practice Address - Country:US
Practice Address - Phone:562-618-5710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95049688163WC0200X
CA95002321367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine