Healthcare Provider Details

I. General information

NPI: 1154290823
Provider Name (Legal Business Name): RENEE CORTEZ MM, MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2025
Last Update Date: 11/01/2025
Certification Date: 11/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S BEACHY PL
ANAHEIM CA
92804-2239
US

IV. Provider business mailing address

8605 SANTA MONICA BLVD PMB 504637
WEST HOLLYWOOD CA
90069-4109
US

V. Phone/Fax

Practice location:
  • Phone: 714-883-6149
  • Fax:
Mailing address:
  • Phone: 714-883-6149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number08475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: