Individual provider Active NPI

Lauretta K Montes, PH.D.

  • Clinical Psychologist
  • Ventura, CA
National Provider Identifier
1568830776
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY32160 Issued in CA
Practice address
290 Maple CT Ste 112
Ventura, CA 93003-3517
Phone
(805) 746-7136
Fax
(805) 947-1007
NPI assigned
Sep 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Psychologist 103TC0700X PSY32160 CA Primary

Addresses

Primary practice location

290 Maple CT Ste 112
Ventura, CA 93003-3517

Mailing address

290 Maple CT Ste 112
Ventura, CA 93003-3517
Phone (805) 746-7136

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210104002056 CA Practitioner - Clinical Psychologist 1456764893 Practice locations: Ventura, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1190 S Victoria Ave
Suite 106
Ventura, CA 93003-6543
Phone (805) 746-7136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY32160CAMDClinical Psychologist
32160CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Montes Clinical Psychology Group, Inc. Clinical CurrentSince Apr 9, 2023 Accepting new patients

Locations

290 Maple Ct
Ste 112
Ventura, CA 93003
Phone (805) 746-7136

1190 S Victoria Ave
Ste 106
Ventura, CA 93003
Phone (805) 746-7136

Organizations & group practices 1

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1568830776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 MAPLE CT STE 112",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033517",
            "telephone_number": "805-746-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 MAPLE CT STE 112",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033517",
            "telephone_number": "805-746-7136",
            "fax_number": "805-947-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES",
        "first_name": "LAURETTA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-03",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY32160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

Verify at the official NPI Registry.