Healthcare Provider Details

I. General information

NPI: 1174994040
Provider Name (Legal Business Name): MICHELLE MARIE MONTOYA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 MAIN ST
OAKLEY CA
94561-3301
US

IV. Provider business mailing address

2005 MAIN ST STE C
OAKLEY CA
94561-3301
US

V. Phone/Fax

Practice location:
  • Phone: 925-776-8223
  • Fax: 925-776-8260
Mailing address:
  • Phone: 925-776-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165486
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: