Individual
DR. AMY DIANE MONTAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
74710 HIGHWAY 111 STE 102, PALM DESERT, CA 92260-3820
(310) 497-7047
Mailing address
260 NEWPORT CENTER DR, STE 209, NEWPORT BEACH, CA 92660-7520
(310) 497-7047
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 16740
CA
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770668097
NPI TYPE II
CA
Enumeration date
01/05/2009
Last updated
09/19/2023
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