Healthcare Provider Details

I. General information

NPI: 1942125836
Provider Name (Legal Business Name): LESLIE D MONTANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16850 BEAR VALLEY RD
VICTORVILLE CA
92395-5794
US

IV. Provider business mailing address

PO BOX 4086
BLUE JAY CA
92317-4086
US

V. Phone/Fax

Practice location:
  • Phone: 760-241-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: