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General NPI Number Information
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NPI Number | 1457778235
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Entity Type | Individual
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Provider Name | LEANN MONTGOMERY
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Gender | Female
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Dates
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Enumeration Date | 03/18/2014
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 1337 HOWE AVE STE 107
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City | SACRAMENTO
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State | CA
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Zip | 95825-3305
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Country | US
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Telephone | 916-564-5010
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Fax |
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Provider Business Mailing Address
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Address Line | 2015 CABRILLO LN
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City | HERCULES
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State | CA
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Zip | 94547-5419
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Country | US
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Telephone | 866-936-7838
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Fax | 866-936-7840
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BACHELORS LEVEL
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License Number State |
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