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NPI Code Detail

MEDICARE: MR. AARON R MONTGOMERY MFT

MEDICARE: MR. AARON R MONTGOMERY MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMFC49608CA
2103TC0700XClinical PsychologistPSY28475CA

General Provider Information

NPI Number : 1720132236
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AARON R MONTGOMERY MFT
Provider Business Mailing Address
First Line : 401 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3303
Country : US
Telephone Number : 714-834-5015
Fax Number :
Provider Business Practice Location Address
First Line : 401 THE CITY DR S
Second Line :
City : ORANGE
State : CA
Zip : 92868-3303
Country : US
Telephone Number : 714-834-5015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 10/10/2016

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