Healthcare Provider Details

I. General information

NPI: 1629676721
Provider Name (Legal Business Name): WENDEE H MONTES-RODRIGUEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDEE HOPE DANIELS

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 11/07/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

200 S MANCHESTER AVE STE 300
ORANGE CA
92868-3219
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-5022
  • Fax:
Mailing address:
  • Phone: 714-456-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95014398
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number012650
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95014398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: