Basic Information
| Provider Information | |||||||||
| NPI: | 1689945503 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MONTEVERDE | ||||||||
| FirstName: | YVONNE | ||||||||
| MiddleName: | GUADALUPE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 314 FIRMIN ST. | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4089102437 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11741 TELEGRAPH RD | ||||||||
| Address2: | |||||||||
| City: | SANTA FE SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906703681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5629498455 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2012 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | N | Other Service Providers | Community Health Worker | 101YM0800X | 100156 | CA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.