Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 1041C0700X | Clinical Social Worker |
NPI | 1003077850 |
---|---|
Provider Name | Christin Michelle Montoya |
First Address | Ceres, CA 95307-4562 |
Second Address | Ceres, CA 95307-4562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 22/09/2021 |