Provider Demographics
NPI:1962542548
Name:ORTEGA, MARIA (LPT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
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Mailing Address - Street 1:9124 CULPEPPER ST
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-1261
Mailing Address - Country:US
Mailing Address - Phone:626-488-9263
Mailing Address - Fax:
Practice Address - Street 1:316 E E ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-3712
Practice Address - Country:US
Practice Address - Phone:909-983-4466
Practice Address - Fax:909-983-1166
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-12-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA31019167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician