Samuel A Montano, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28917 Issued in CA

Practice address

255 W Bullard Ave Ste 101
Clovis, CA 93612-0861

Phone

(559) 443-8687

NPI assigned

Jun 20, 2020

Last updated

Nov 20, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Valley Indian Health IncGroup PAC ID 9931092533, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Valley Indian Health Inc

  • Clinic/Center
  • Prather, CA
  • NPI 1902025059
  Medicare reassignment Care Compare group NPD
• Central Valley Indian Health, Inc.

  • Clinic/Center
  • Clovis, CA
  • NPI 1235670787
  NPD
• Central Valley Indian Health, Inc

  dba CVIH Behavioral Health Services

  • Clinic/Center
  • Clovis, CA
  • NPI 1447668363
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1164048609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-299-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE STE 101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-443-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANO",
        "first_name": "SAMUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gisela Erica Mondragon
• Shirley Mondragon
• Ayanna Montalvo
• Sandra Marie Montalvo, RN
• Anthony W Montana, M.D.
• Stacey Melissa Montes, NP
• Suzanne Montgomery, RNFA
• Lizbeth Montiel-Gonzalez
• Ana Gabriela Monzon
• Ashley Moon, MD

• Clinical Psychologist in Clovis, CA
• Providers in Clovis, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.