Healthcare Provider Details

I. General information

NPI: 1144358656
Provider Name (Legal Business Name): MS. JILL ALISE MONTRE'
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3353 BRADSHAW RD SUITE 103
SACRAMENTO CA
95827-2607
US

IV. Provider business mailing address

1423 26TH ST APT.#3
SACRAMENTO CA
95816-6314
US

V. Phone/Fax

Practice location:
  • Phone: 916-857-1570
  • Fax: 916-857-1580
Mailing address:
  • Phone: 916-455-3163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: