Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | ASW78384 | CA |
Y | 104100000X | Social Worker | LSW2732 | HI |
NPI | 1003304585 |
---|---|
Provider Name | Joel Andres Montes |
First Address | Sunset Beach, CA 90742-1596 |
Second Address | Long Beach, CA 90822-5201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2018 |
Last Update Date | 10/09/2020 |