Healthcare Provider Details

I. General information

NPI: 1386217875
Provider Name (Legal Business Name): LAURA ORTEGA ARIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA ORTEGA ARIAS

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S 2ND AVE
COVINA CA
91723-3017
US

IV. Provider business mailing address

1817 2ND ST APT 18
DUARTE CA
91010-1818
US

V. Phone/Fax

Practice location:
  • Phone: 626-974-8123
  • Fax: 626-974-8198
Mailing address:
  • Phone: 626-320-0520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: