Healthcare Provider Details

I. General information

NPI: 1902458367
Provider Name (Legal Business Name): CECILE ORTIZ NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23421 LYONS AVE
SANTA CLARITA CA
91355-3028
US

IV. Provider business mailing address

23421 LYONS AVE
SANTA CLARITA CA
91355-3028
US

V. Phone/Fax

Practice location:
  • Phone: 661-244-1835
  • Fax:
Mailing address:
  • Phone: 661-244-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95012707
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAG05190040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: