Healthcare Provider Details

I. General information

NPI: 1194630343
Provider Name (Legal Business Name): EMILY MONTANEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E BROADWAY
GLENDALE CA
91205-1407
US

IV. Provider business mailing address

512 S EUCLID AVE UNIT 1
PASADENA CA
91101-3264
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-6834
  • Fax:
Mailing address:
  • Phone: 323-707-2178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number9821
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: