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General NPI Number Information
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NPI Number | 1912008558
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Entity Type | Individual
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Provider Name | MR. JORGE JAVIER MONTOYA
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 211 W COMMONWEALTH AVE
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City | FULLERTON
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State | CA
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Zip | 92832-1810
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Country | US
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Telephone | 714-447-7099
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Fax | 714-447-7015
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Provider Business Mailing Address
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Address Line | 3441 E CALLE BAJA DR
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City | WEST COVINA
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State | CA
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Zip | 91792-2906
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Country | US
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Telephone | 909-595-5293
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | IMF41368
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | IMF41368
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License Number State | CA
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