Healthcare Provider Details

I. General information

NPI: 1083268445
Provider Name (Legal Business Name): MELANIE ORTEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3482 SADDLE DR
SPRING VALLEY CA
91977-2035
US

IV. Provider business mailing address

4950 WARING RD
SAN DIEGO CA
92120-2731
US

V. Phone/Fax

Practice location:
  • Phone: 619-660-3886
  • Fax:
Mailing address:
  • Phone: 619-660-3886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number116764
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: