Individual provider Active NPI

Betty Montemayor, ACSW

  • Clinical Social Worker
  • El Dorado Hills, CA
National Provider Identifier
1174923981
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
94701 Issued in CA
Practice address
3440 El Dorado Hills Blvd Apt 103
El Dorado Hills, CA 95762-4481
Phone
(559) 356-8141
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 94701 CA Primary

Addresses

Primary practice location

3440 El Dorado Hills Blvd Apt 103
El Dorado Hills, CA 95762-4481

Mailing address

3440 El Dorado Hills Blvd Apt 103
El Dorado Hills, CA 95762-4481
Phone (559) 356-8141

Other names 1

  • Betty A Montemayor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
94701CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Youth Services of Fresno, Inc. (Functional Family Therap PastSince Mar 1, 2020 Accepting new patients
Comprehensive Youth Services of Fresno, Inc. PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1174923981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 EL DORADO HILLS BLVD APT 103",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957624481",
            "telephone_number": "559-356-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 EL DORADO HILLS BLVD APT 103",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957624481",
            "telephone_number": "559-356-8141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEMAYOR",
        "first_name": "BETTY",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-28",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "94701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETTY",
            "last_name": "MONTEMAYOR",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.