Provider Demographics
NPI:1669745444
Name:MONTES, ANGELA (BCBA, CF-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MONTES
Suffix:
Gender:F
Credentials:BCBA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 N HOLLYWOOD WAY
Mailing Address - Street 2:#304
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1055
Mailing Address - Country:US
Mailing Address - Phone:866-278-5011
Mailing Address - Fax:
Practice Address - Street 1:14207 E 14TH ST
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-2709
Practice Address - Country:US
Practice Address - Phone:102-209-5785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8797103K00000X
CA19618235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst