MEDICARE: GUADALUPE ELIZABETH ORTIZ MS, AMFT, APCC

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	106H00000X	Marriage & Family Therapist	151164	CA

General Provider Information

NPI Number	:	1689149676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUADALUPE ELIZABETH ORTIZ MS, AMFT, APCC

Provider Business Mailing Address
First Line	:	2226 N 1ST ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2007
Country	:	US
Telephone Number	:	408-841-4309
Fax Number	:	408-841-4101

Provider Business Practice Location Address
First Line	:	2226 N 1ST ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95131-2007
Country	:	US
Telephone Number	:	408-841-4309
Fax Number	:	408-841-4101

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

Provider Enumeration Date	:	10/05/2018
Last Update Date	:	12/02/2025

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