Provider Demographics
NPI:1881760825
Name:MONTEZ, REBECCA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MONTEZ
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:JAUREGUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICENSED VOCATIONAL
Mailing Address - Street 1:2550 W CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93705-4201
Mailing Address - Country:US
Mailing Address - Phone:559-264-7521
Mailing Address - Fax:559-233-0016
Practice Address - Street 1:2550 W CLINTON AVE BLDG W AND BLDG A
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93705-4201
Practice Address - Country:US
Practice Address - Phone:559-264-7521
Practice Address - Fax:559-233-0016
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA834489163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse