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NPI Code Detail

MEDICARE: VICTOR ORTEGA PMHNP

MEDICARE:   VICTOR  ORTEGA  PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN260786GA

General Provider Information

NPI Number : 1922891050
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTOR ORTEGA PMHNP
Provider Business Mailing Address
First Line : 407 COOPERS POND DR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-5231
Country : US
Telephone Number : 240-565-1688
Fax Number : 470-221-1659
Provider Business Practice Location Address
First Line : 1910 S STAPLEY DR STE 120
Second Line :
City : MESA
State : AZ
Zip : 85204-6676
Country : US
Telephone Number : 240-565-1688
Fax Number : 470-221-1659
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2025
Last Update Date : 02/14/2026

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Directions to “ VICTOR ORTEGA PMHNP” Practice Location

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