Provider Demographics
NPI:1487155784
Name:ORTIZ, JESSICA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
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 1:12408 NORTE CHICO PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-5501
Mailing Address - Country:US
Mailing Address - Phone:915-274-4322
Mailing Address - Fax:
Practice Address - Street 1:1512 N ZARAGOZA RD STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-8903
Practice Address - Country:US
Practice Address - Phone:915-855-0601
Practice Address - Fax:915-855-0751
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist