Healthcare Provider Details

I. General information

NPI: 1215191713
Provider Name (Legal Business Name): MS. CLAUDIA MONTOYA MEJIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 BROADWAY
RICHMOND CA
94804-1910
US

IV. Provider business mailing address

84 BROADWAY
RICHMOND CA
94804-1910
US

V. Phone/Fax

Practice location:
  • Phone: 510-231-7810
  • Fax: 510-231-7812
Mailing address:
  • Phone: 510-231-7810
  • Fax: 510-231-7812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: