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General NPI Number Information
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NPI Number | 1922891050
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Entity Type | Individual
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Provider Name | VICTOR ORTEGA PMHNP
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Gender | Male
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 3495 PIEDMONT RD NE BLDG 11-121
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City | ATLANTA
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State | GA
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Zip | 30305-1974
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Country | US
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Telephone | 470-684-6262
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Fax |
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Provider Business Mailing Address
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Address Line | 407 COOPERS POND DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5231
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Country | US
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Telephone | 240-565-1688
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Fax | 470-221-1659
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 322885
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License Number State | AZ
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