MEDICARE: BRENDA ORTIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor

General Provider Information

NPI Number	:	1528920360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA ORTIZ

Provider Business Mailing Address
First Line	:	294 GREEN VALLEY RD
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-1300
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2350 E LAKE AVE
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-1428
Country	:	US
Telephone Number	:	831-728-6455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ BRENDA ORTIZ ” Practice Location

Language	Start Address	Practice Location

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