MEDICARE: JOSHUA 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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1083595649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA ORTIZ

Provider Business Mailing Address
First Line	:	131 STATE ROAD 503 UNIT A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87506-9774
Country	:	US
Telephone Number	:	505-469-1011
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 STATE ROAD 503 UNIT A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87506-9774
Country	:	US
Telephone Number	:	505-469-1011
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2025
Last Update Date	:	09/25/2025

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Directions to “ JOSHUA ORTIZ ” Practice Location

Language	Start Address	Practice Location

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