Provider Demographics
NPI:1679738041
Name:MONTIEL, ELIETTE DEL CARMEN
Entity type:Individual
Prefix:MS
First Name:ELIETTE
Middle Name:DEL CARMEN
Last Name:MONTIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S HILL ST STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-3523
Mailing Address - Country:US
Mailing Address - Phone:213-255-9753
Mailing Address - Fax:
Practice Address - Street 1:222 S HILL ST STE 600
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012-3523
Practice Address - Country:US
Practice Address - Phone:213-255-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
CA639071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker