Healthcare Provider Details
I. General information
NPI: 1235705369
Provider Name (Legal Business Name): MRS. ELIZABETH MONTES DE OCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/30/2021
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 DISTRICT CENTER DR
PALM SPRINGS CA
92264-3626
US
IV. Provider business mailing address
150 DISTRICT CENTER DR
PALM SPRINGS CA
92264-3626
US
V. Phone/Fax
- Phone: 760-459-8922
- Fax: 760-325-8723
- Phone: 760-459-8922
- Fax: 760-325-8723
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCSW83212 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: