Provider Demographics
NPI:1811519549
Name:BRIONES-MONTIEL, VERONICA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BRIONES-MONTIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VERONICA
Other - Middle Name:RENE
Other - Last Name:BRIONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC III, MBA
Mailing Address - Street 1:1225 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92703-2101
Mailing Address - Country:US
Mailing Address - Phone:657-216-7740
Mailing Address - Fax:
Practice Address - Street 1:1225 W 6TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703-2101
Practice Address - Country:US
Practice Address - Phone:657-216-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABII00220520101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty