Basic Information
| Provider Information | |||||||||
| NPI: | 1326595430 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORTEZ | ||||||||
| FirstName: | ALVARO | ||||||||
| MiddleName: | JOSE | ||||||||
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| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21545 CENTRE POINTE PKWY | ||||||||
| Address2: | |||||||||
| City: | SANTA CLARITA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913502947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612599439 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4900 SERRANIA AVE | ||||||||
| Address2: | |||||||||
| City: | WOODLAND HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913643301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183471577 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2016 | ||||||||
| LastUpdateDate: | 09/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 1041C0700X | ASW78570 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 1041C0700X | 110042 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.