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General NPI Number Information
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NPI Number | 1932833761
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Entity Type | Individual
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Provider Name | STEVEN WYATT ORDONIO
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Gender | Male
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Dates
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Enumeration Date | 07/16/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 9890 COUNTY FARM RD STE 2
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City | RIVERSIDE
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State | CA
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Zip | 92503-3678
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Country | US
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Telephone | 510-337-7950
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Fax |
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Provider Business Mailing Address
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Address Line | 3131 ARLINGTON AVE APT 94
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City | RIVERSIDE
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State | CA
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Zip | 92506-3241
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Country | US
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Telephone | 951-300-8291
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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 | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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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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