Healthcare Provider Details

I. General information

NPI: 1407004518
Provider Name (Legal Business Name): JOSE FRANCISCO MONTES PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 03/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9036 RESEDA BLVD STE 204
NORTHRIDGE CA
91324-5895
US

IV. Provider business mailing address

4140 VERDUGO RD APT 1
LOS ANGELES CA
90065-3831
US

V. Phone/Fax

Practice location:
  • Phone: 213-202-3970
  • Fax:
Mailing address:
  • Phone: 818-812-6645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY27883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: