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General NPI Number Information
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NPI Number | 1922328251
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Entity Type | Individual
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Provider Name | DEBBRA ANN MONTOYA PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 1 BLACKFIELD DR SUITE # 314
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City | TIBURON
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State | CA
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Zip | 94920-2053
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Country | US
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Telephone | 415-728-3796
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Fax | 415-789-5465
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Provider Business Mailing Address
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Address Line | 1 BLACKFIELD DR SUITE # 314
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City | TIBURON
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State | CA
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Zip | 94920-2053
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Country | US
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Telephone | 415-728-3796
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Fax | 415-789-5465
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 15475
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA748
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License Number State | NV
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