Healthcare Provider Details

I. General information

NPI: 1518626860
Provider Name (Legal Business Name): LOREN JOSEPH ORTIZ CPSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 LOS ARBOLES AVE NE
ALBUQUERQUE NM
87107-1943
US

IV. Provider business mailing address

306 CABEZA NEGRA DR SE
RIO RANCHO NM
87124-1346
US

V. Phone/Fax

Practice location:
  • Phone: 505-800-7092
  • Fax: 505-888-2851
Mailing address:
  • Phone: 505-999-8234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: