Healthcare Provider Details

I. General information

NPI: 1972059285
Provider Name (Legal Business Name): LAUREN ORTIZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2016
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 MESA PALMS DR
ST GEORGE UT
84770-5546
US

IV. Provider business mailing address

2044 MESA PALMS DR
ST GEORGE UT
84770-5546
US

V. Phone/Fax

Practice location:
  • Phone: 435-673-5353
  • Fax:
Mailing address:
  • Phone: 805-208-5874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number12254635-4201
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17915
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: