Individual provider Active NPI

Angelica G Montgomery, ACSW

  • Clinical Social Worker
  • Upland, CA
National Provider Identifier
1235890542
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
134221 Issued in CA
Practice address
231 N Euclid Ave
Upland, CA 91786-6038
Phone
(760) 792-6630
NPI assigned
Jan 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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 134221 CA Primary

Addresses

Primary practice location

231 N Euclid Ave
Upland, CA 91786-6038

Mailing address

231 N Euclid Ave
Upland, CA 91786-6038
Phone (760) 792-6630

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15497 W Sand St
Victorville, CA 92392-2910

22808 El Centro Rd
Apple Valley, CA 92307-1998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134221CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Star Behavioral Health, Inc. PastSince Jan 1, 2022 Accepting new patients
Valley Star Behavioral Health, Inc. PastSince Jan 1, 2022 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": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1235890542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 N EUCLID AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866038",
            "telephone_number": "760-792-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 N EUCLID AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917866038",
            "telephone_number": "760-792-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ANGELICA",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "134221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.