Active NPI
Clinton Montgomery, M.D.
- Psychiatry Physician
- Northridge, CA
National Provider Identifier
1255455358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- G9620
- Practice address
- 9650 Zelzah Ave
Northridge, CA 91325-2003 - Phone
- (818) 993-9311
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | G9620 | CA | Primary |
Addresses
Primary practice location
9650 Zelzah Ave
Northridge, CA 91325-2003
Mailing address
9650 Zelzah Ave
Northridge, CA 91325-2003
Phone (661) 265-8627
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G9620 | CA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1255455358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9650 ZELZAH AVE",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913252003",
"telephone_number": "661-265-8627",
"fax_number": "661-265-7936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9650 ZELZAH AVE",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913252003",
"telephone_number": "818-993-9311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTGOMERY",
"first_name": "CLINTON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CA",
"license": "G9620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.