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NPI Code Detail

MEDICARE: RENE MONTIJO A067980426

MEDICARE: RENE MONTIJO A067980426
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorRH0015910825CA

General Provider Information

NPI Number : 1235745639
Entity Type Code : Individual
Provider Name (Legal Business Name) : RENE MONTIJO A067980426
Provider Business Mailing Address
First Line : 14530 SYLVAN ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2324
Country : US
Telephone Number : 323-222-1440
Fax Number :
Provider Business Practice Location Address
First Line : 14530 SYLVAN ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2324
Country : US
Telephone Number : 323-222-1440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2020
Last Update Date : 04/02/2026

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Directions to “ RENE MONTIJO A067980426” Practice Location

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