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Organization
MONTCLAIR COMMUNITY CLINIC
Active
Organization
MONTCLAIR COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENOYE R UKU (OWNER)
(206) 456-6933
Entity
Organization
Contact information
Practice address
9655 MONTE VISTA AVE STE 402A, MONTCLAIR, CA 91763-2238
(909) 972-0924
(909) 966-4987
Mailing address
9655 MONTE VISTA AVE STE 402A, MONTCLAIR, CA 91763-2238
(909) 972-0924
(909) 966-4987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/23/2024
Last updated
03/11/2026
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