Healthcare Provider Details

I. General information

NPI: 1578033080
Provider Name (Legal Business Name): ANAHI CORTEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GEER RD
TURLOCK CA
95380-3311
US

IV. Provider business mailing address

875 GEER RD
TURLOCK CA
95380-3311
US

V. Phone/Fax

Practice location:
  • Phone: 209-633-3057
  • Fax: 209-633-3031
Mailing address:
  • Phone: 209-633-3057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC12281
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: