Healthcare Provider Details

I. General information

NPI: 1699373670
Provider Name (Legal Business Name): LUIS OROZCO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2020
Last Update Date: 10/13/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 BOWWOOD ST.
GRIDLEY CA
95948
US

IV. Provider business mailing address

990 KLAMATH LN STE 20
YUBA CITY CA
95993-8979
US

V. Phone/Fax

Practice location:
  • Phone: 530-492-9375
  • Fax:
Mailing address:
  • Phone: 916-729-3098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: