Healthcare Provider Details

I. General information

NPI: 1710482799
Provider Name (Legal Business Name): TANIA MONTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2018
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1402 W PICO AVE # 208
EL CENTRO CA
92243-1377
US

IV. Provider business mailing address

1402 W PICO AVE # 208
EL CENTRO CA
92243-1377
US

V. Phone/Fax

Practice location:
  • Phone: 442-235-9103
  • Fax:
Mailing address:
  • Phone: 442-235-9103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number131253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: