Healthcare Provider Details

I. General information

NPI: 1942978804
Provider Name (Legal Business Name): JOSEPHINE ORTEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2021
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 NATIVIDAD RD
SALINAS CA
93906-3144
US

IV. Provider business mailing address

1270 NATIVIDAD RD
SALINAS CA
93906-3144
US

V. Phone/Fax

Practice location:
  • Phone: 831-755-4510
  • Fax:
Mailing address:
  • Phone: 831-755-4510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW109354
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberASW109354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: