Individual provider Active NPI

Dellia Montgomery, RNP

  • Women's Health Nurse Practitioner
  • Orange, CA
National Provider Identifier
1467856518
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
10580 Issued in CA
Practice address
805 W la Veta Ave Ste 107
Orange, CA 92868-3928
Phone
(714) 771-7123
Fax
(714) 771-0249
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 10580 CA Primary

Addresses

Primary practice location

805 W la Veta Ave Ste 107
Orange, CA 92868-3928

Mailing address

279 Imperial Hwy
Ste 730
Fullerton, CA 92835-1041
Phone (714) 578-8544

Other identifiers 1

IdentifierTypeStateIssuer
NP10580OtherCARNP

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

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1467856518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 IMPERIAL HWY",
            "address_2": "STE 730",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928351041",
            "telephone_number": "714-578-8544",
            "fax_number": "714-449-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W LA VETA AVE STE 107",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683928",
            "telephone_number": "714-771-7123",
            "fax_number": "714-771-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "DELLIA",
        "credential": "RNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "10580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RNP",
            "identifier": "NP10580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.