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General NPI Number Information
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NPI Number | 1982468930
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Entity Type | Individual
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Provider Name | MARISOL MONTERO FNP
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Gender | Female
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 10 E CHARTER WAY
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City | STOCKTON
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State | CA
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Zip | 95206-2075
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Country | US
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Telephone | 209-460-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 OTIS DR
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City | ALAMEDA
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State | CA
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Zip | 94501-6326
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Country | US
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Telephone | 510-409-8021
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95029038
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License Number State | CA
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