MEDICARE: SYLVIA MONTANO

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	103TA0700X	Adult Development & Aging Psychologist

General Provider Information

NPI Number	:	1912426024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA MONTANO

Provider Business Mailing Address
First Line	:	2001 S. BARRINGTON AVE., SUITE 219
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S BARRINGTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5363
Country	:	US
Telephone Number	:	424-248-7727
Fax Number	:

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

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	09/11/2017

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Directions to “ SYLVIA MONTANO ” Practice Location

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