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General NPI Number Information
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NPI Number | 1790061299
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Entity Type | Individual
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Provider Name | LUCIANA DIAS MONTEIRO
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Gender | Female
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 16264 CHURCH ST SUITE 103
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City | MORGAN HILL
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State | CA
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Zip | 95037-7130
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Country | US
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Telephone | 408-779-2113
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W CAMPBELL AVE 102
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City | CAMPBELL
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State | CA
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Zip | 95008-1526
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Country | US
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Telephone | 408-871-4924
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF75265
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT 94701
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License Number State | CA
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