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General NPI Number Information
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NPI Number | 1093564023
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Entity Type | Individual
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Provider Name | BAMBIE ANN E ORTEGA
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Gender | Female
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Dates
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Enumeration Date | 05/13/2024
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 4546 EL CAMINO REAL STE B7
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City | LOS ALTOS
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State | CA
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Zip | 94022-1069
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Country | US
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Telephone | 866-362-4246
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Fax |
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Provider Business Mailing Address
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Address Line | 27273 EDGEMONT LN
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City | SANTA CLARITA
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State | CA
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Zip | 91350-8568
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Country | US
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Telephone | 818-205-7125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 95201036
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95030868
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License Number State | CA
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