Provider Demographics
NPI:1386164010
Name:MONTOYA, LINDA ANN (106S00000X)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:106S00000X
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 ANACAPA DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-5947
Mailing Address - Country:US
Mailing Address - Phone:916-622-9842
Mailing Address - Fax:
Practice Address - Street 1:405 ANACAPA DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-5947
Practice Address - Country:US
Practice Address - Phone:916-671-4866
Practice Address - Fax:916-671-4866
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician