Provider Demographics
NPI:1831593912
Name:MONTOJO, CARMELA TRINIDAD (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:CARMELA
Middle Name:TRINIDAD
Last Name:MONTOJO
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 W 6TH ST STE 305
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-1121
Mailing Address - Country:US
Mailing Address - Phone:909-858-0977
Mailing Address - Fax:
Practice Address - Street 1:1131 W 6TH ST STE 305
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-1121
Practice Address - Country:US
Practice Address - Phone:909-858-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-17
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily