Healthcare Provider Details

I. General information

NPI: 1427923812
Provider Name (Legal Business Name): BRIANNA MONTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 F ST 100
CHULA VISTA CA
91910
US

IV. Provider business mailing address

330 MOSS ST
CHULA VISTA CA
91911-2005
US

V. Phone/Fax

Practice location:
  • Phone: 858-272-2662
  • Fax: 858-272-2661
Mailing address:
  • Phone: 619-585-4221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-471655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: