Jacquelynn Montgomery, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

81826 Issued in CA

Practice address

706 13TH St
Modesto, CA 95354-2414

Phone

(209) 284-4649

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Marriage and Family Therapist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1528254034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3548",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953523548",
            "telephone_number": "209-284-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 13TH ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953542414",
            "telephone_number": "209-284-4649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "516 N Kaweah Ave",
            "address_purpose": "LOCATION",
            "city": "Exeter",
            "state": "CA",
            "postal_code": "932211200",
            "country_code": "US",
            "telephone_number": "559-594-4969",
            "fax_number": "559-594-4308",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 N 9th St Ste A",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953505814",
            "country_code": "US",
            "telephone_number": "209-558-4640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "JACQUELYNN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "81826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528254034",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gisela Monserrat Montes-Morales
• Fernanda Montes
• Maria Montes, LCSW
• Andre Montez
• Marie F. Montfort, MD
• Jessika Montiel Gonzalez
• Aemberly Montilla
• Flor De Amor Montoya-Garcia
• Julie Montoya
• Maribel Montoya

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.