Provider Demographics
NPI:1063007474
Name:ORDONEZ, NATALIA
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ORDONEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25398 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-8529
Mailing Address - Country:US
Mailing Address - Phone:707-972-6472
Mailing Address - Fax:
Practice Address - Street 1:25398 BROWN RD
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-8529
Practice Address - Country:US
Practice Address - Phone:707-972-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician