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NPI Code Detail

MEDICARE: ITZELT MARICRUZ CORTEZ

MEDICARE:   ITZELT MARICRUZ CORTEZ
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
2390200000XStudent in an Organized Health Care Education/Training ProgramCA
3372600000XAdult CompanionCA

General Provider Information

NPI Number : 1114633302
Entity Type Code : Individual
Provider Name (Legal Business Name) : ITZELT MARICRUZ CORTEZ
Provider Business Mailing Address
First Line : 1965 LIVE OAK BLVD
Second Line :
City : YUBA CITY
State : CA
Zip : 95991-8850
Country : US
Telephone Number : 530-822-7200
Fax Number :
Provider Business Practice Location Address
First Line : 1445 VETERANS MEMORIAL CIR
Second Line :
City : YUBA CITY
State : CA
Zip : 95993-3011
Country : US
Telephone Number : 530-822-5999
Fax Number : 530-822-7223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2023
Last Update Date : 03/23/2026

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Directions to “ ITZELT MARICRUZ CORTEZ ” Practice Location

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