Healthcare Provider Details

I. General information

NPI: 1407973878
Provider Name (Legal Business Name): LAUREL I MONTGOMERY NP MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE FL BLDG.9-2ND SFGH - OCCUPATIONAL HEALTH SERVICE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE FL BLDG.9-2ND SFGH - OCCUPATIONAL HEALTH SERVICE
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-6581
  • Fax: 415-206-3669
Mailing address:
  • Phone: 415-206-6581
  • Fax: 415-206-3669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License NumberRN476780
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License NumberNPF8976
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: