Provider Demographics
NPI:1740982875
Name:MONTALVO, MARY ARLENE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ARLENE
Last Name:MONTALVO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 VEGA DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2010
Mailing Address - Country:US
Mailing Address - Phone:805-335-3889
Mailing Address - Fax:
Practice Address - Street 1:617 GARDEN ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1664
Practice Address - Country:US
Practice Address - Phone:805-845-3246
Practice Address - Fax:805-884-8445
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health