Amy K Montague, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY11212

Practice address

4180 La Jolla VLG Dr
Suite 250
La Jolla, CA 92037

Phone

(858) 554-0801

Fax

(858) 054-0821

NPI assigned

Sep 27, 2006

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

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639260722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 LA JOLLA VLG DR",
            "address_2": "SUITE 250",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-554-0801",
            "fax_number": "858-054-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 LA JOLLA VLG DR",
            "address_2": "SUITE 250",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "92037",
            "telephone_number": "858-554-0801",
            "fax_number": "858-054-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTAGUE",
        "first_name": "AMY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": "PSY11212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CP11212",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mason Montano
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• Oscar Monzon
• Minjung Jane Moon, MD

• Psychologist in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.