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General NPI Number Information
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NPI Number | 1578146783
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Entity Type | Individual
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Provider Name | COURTNEY REGINA MONTGOMERY NP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1080 EMELINE AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95060-1966
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Country | US
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Telephone | 831-454-4100
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Fax | 831-454-4488
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Provider Business Mailing Address
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Address Line | 200 7TH AVE STE 150
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City | SANTA CRUZ
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State | CA
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Zip | 95062-4669
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Country | US
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Telephone | 831-462-1060
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Fax | 831-462-4970
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95018193
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License Number State | CA
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