Healthcare Provider Details

I. General information

NPI: 1104753565
Provider Name (Legal Business Name): JOEL ALEJANDRO ORTIZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 S A ST
PORTERVILLE CA
93257-4844
US

IV. Provider business mailing address

277 S A ST
PORTERVILLE CA
93257-4844
US

V. Phone/Fax

Practice location:
  • Phone: 559-792-5227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: