MEDICARE: CLAUDIA ORTIZ CRUZ LMSW

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1255877601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA ORTIZ CRUZ LMSW

Provider Business Mailing Address
First Line	:	3688 HIDDEN BEACH CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-1285
Country	:	US
Telephone Number	:	702-704-9465
Fax Number	:

Provider Business Practice Location Address
First Line	:	3965 E OWENS AVE STE 180
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89110-7034
Country	:	US
Telephone Number	:	702-331-5983
Fax Number	:

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

Provider Enumeration Date	:	01/10/2017
Last Update Date	:	04/27/2021

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