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Individual

DEBBRA ANN MONTOYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1 BLACKFIELD DR, SUITE # 314, TIBURON, CA 94920-2053
(415) 728-3796
(415) 789-5465
Mailing address
1 BLACKFIELD DR, SUITE # 314, TIBURON, CA 94920-2053
(415) 728-3796
(415) 789-5465

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
15475
CA
363AM0700X
Medical Physician Assistant
Primary
PA748
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447316310
NV
Enumeration date
06/09/2010
Last updated
08/24/2015
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