Healthcare Provider Details

I. General information

NPI: 1205765252
Provider Name (Legal Business Name): PAIGE LORAL ORTIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 CENTRAL AVE
SALINAS CA
93901-2651
US

IV. Provider business mailing address

183 PADDON PL APT B
MARINA CA
93933-2953
US

V. Phone/Fax

Practice location:
  • Phone: 831-208-6207
  • Fax: 844-209-1290
Mailing address:
  • Phone: 831-417-6921
  • Fax: 831-417-6921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberW9382231
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: