Provider Demographics
NPI:1902945645
Name:ORTEGA, ROSEMARY (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CITADEL DR STE 175
Mailing Address - Street 2:CONCEPT 7
Mailing Address - City:COMMERCE
Mailing Address - State:CA
Mailing Address - Zip Code:90040-1577
Mailing Address - Country:US
Mailing Address - Phone:323-838-9566
Mailing Address - Fax:323-838-9566
Practice Address - Street 1:200 CITADEL DR STE 175
Practice Address - Street 2:CONCEPT 7
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-1577
Practice Address - Country:US
Practice Address - Phone:323-838-9566
Practice Address - Fax:323-838-9566
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS220781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical