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NPI Code Detail

MEDICARE: CASSARA ORTIZ

MEDICARE: CASSARA ORTIZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1033800248
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSARA ORTIZ
Provider Business Mailing Address
First Line : 2865 SUNRISE BLVD STE 112
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95742-6108
Country : US
Telephone Number : 916-629-9495
Fax Number :
Provider Business Practice Location Address
First Line : 2865 SUNRISE BLVD STE 112
Second Line :
City : RANCHO CORDOVA
State : CA
Zip : 95742-6108
Country : US
Telephone Number : 916-620-9495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2023
Last Update Date : 05/18/2023

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Directions to “ CASSARA ORTIZ ” Practice Location

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