Provider Demographics
NPI:1225878242
Name:ORTIZ, YARITZA ISABEL
Entity type:Individual
Prefix:
First Name:YARITZA
Middle Name:ISABEL
Last Name:ORTIZ
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 1:161 AVE CHARDON # 161
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1712
Mailing Address - Country:US
Mailing Address - Phone:787-480-4265
Mailing Address - Fax:
Practice Address - Street 1:161 AVE CHARDON # 161
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1712
Practice Address - Country:US
Practice Address - Phone:787-480-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14734104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker