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General NPI Number Information
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NPI Number | 1922831577
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Entity Type | Individual
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Provider Name | MARCELLA ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 08/20/2024
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1700 S AMPHLETT BLVD STE 120
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City | SAN MATEO
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State | CA
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Zip | 94402-2711
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Country | US
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Telephone | 650-683-0882
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 S AMPHLETT BLVD STE 120
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City | SAN MATEO
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State | CA
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Zip | 94402-2711
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Country | US
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Telephone | 650-683-2428
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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