Provider Demographics
NPI:1649854407
Name:MONTALBANO, FILIPPO (MS)
Entity type:Individual
Prefix:MR
First Name:FILIPPO
Middle Name:
Last Name:MONTALBANO
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14979 PORTOFINO CIR
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-1872
Mailing Address - Country:US
Mailing Address - Phone:415-629-6987
Mailing Address - Fax:
Practice Address - Street 1:2138 CEDAR ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1528
Practice Address - Country:US
Practice Address - Phone:510-930-8090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician