MEDICARE: LUPE MONTERO

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	101YS0200X	School Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7896	OTHER		COUNSELOR

General Provider Information

NPI Number	:	1891986543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUPE MONTERO

Provider Business Mailing Address
First Line	:	6926 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6926 MELROSE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3306
Country	:	US
Telephone Number	:	323-934-7979
Fax Number	:

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

Provider Enumeration Date	:	08/07/2007
Last Update Date	:	08/07/2007

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Directions to “ LUPE MONTERO ” Practice Location

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