Healthcare Provider Details

I. General information

NPI: 1922159573
Provider Name (Legal Business Name): YESENIA ORTIZ NURSE, COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 BERNAL RD
SAN JOSE CA
95119-1809
US

IV. Provider business mailing address

298 BERNAL RD
SAN JOSE CA
95119-1809
US

V. Phone/Fax

Practice location:
  • Phone: 408-638-4744
  • Fax:
Mailing address:
  • Phone: 408-638-4744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License NumberPT31716
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberPT31716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: