Healthcare Provider Details

I. General information

NPI: 1265378319
Provider Name (Legal Business Name): ALEXANDRA LAUREN MONTANO O'SHEA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 MOUNT VERNON ST
LEMON GROVE CA
91945-3398
US

IV. Provider business mailing address

8350 MOUNT VERNON ST
LEMON GROVE CA
91945-3398
US

V. Phone/Fax

Practice location:
  • Phone: 619-825-5613
  • Fax:
Mailing address:
  • Phone: 619-825-5613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number108844
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: