MEDICARE: DIANA MONTERROSO

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1245196823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA MONTERROSO

Provider Business Mailing Address
First Line	:	100 N PACIFIC COAST HWY STE 1400
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-5602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3467 FLOWER ST
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-6123
Country	:	US
Telephone Number	:	323-370-3245
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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Directions to “ DIANA MONTERROSO ” Practice Location

Language	Start Address	Practice Location

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