Provider Demographics
NPI:1124339940
Name:MONTES, JESSE (LCSW)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:
Last Name:MONTES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11401 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-2015
Mailing Address - Country:US
Mailing Address - Phone:562-651-4346
Mailing Address - Fax:562-929-1369
Practice Address - Street 1:11401 BLOOMFIELD AVE
Practice Address - Street 2:PROGRAM III
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2015
Practice Address - Country:US
Practice Address - Phone:562-651-4346
Practice Address - Fax:562-929-1369
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA291151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical