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General NPI Number Information
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NPI Number | 1992657878
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Entity Type | Individual
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Provider Name | GLORIA AMANDA ORNELAS CAT
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Gender | Female
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 2429 S PRAIRIE AVE
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City | PUEBLO
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State | CO
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Zip | 81005-2886
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Country | US
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Telephone | 719-564-5070
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W 12TH ST APT 1
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City | PUEBLO
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State | CO
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Zip | 81003-2855
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Country | US
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Telephone | 719-248-9583
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Fax | 719-248-9583
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 106S00000X
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License Number State | CO
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