Provider Demographics
NPI:1629869847
Name:MONTANO, MARLENA
Entity type:Individual
Prefix:
First Name:MARLENA
Middle Name:
Last Name:MONTANO
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30592 CALLE PINA COLADA
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-1552
Mailing Address - Country:US
Mailing Address - Phone:951-409-5335
Mailing Address - Fax:
Practice Address - Street 1:30592 CALLE PINA COLADA
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-1552
Practice Address - Country:US
Practice Address - Phone:951-409-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician