Healthcare Provider Details

I. General information

NPI: 1609144500
Provider Name (Legal Business Name): MARIA-MAGDALENA ORTIZ-NANCE M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 N DEMAREE ST
VISALIA CA
93291-4119
US

IV. Provider business mailing address

6941 E CORNELL AVE
FRESNO CA
93727-1444
US

V. Phone/Fax

Practice location:
  • Phone: 559-635-4252
  • Fax:
Mailing address:
  • Phone: 559-292-5235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: