Healthcare Provider Details

I. General information

NPI: 1518190412
Provider Name (Legal Business Name): CHRISTY M ORTEGA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KINGS COUNTY DR STE 104
HANFORD CA
93230-5954
US

IV. Provider business mailing address

711 N COURT ST STE B
VISALIA CA
93291-3638
US

V. Phone/Fax

Practice location:
  • Phone: 559-754-3128
  • Fax:
Mailing address:
  • Phone: 559-627-1490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number99491
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: