1457735581 NPI number — ORIZBETH CORTES MSW

Table of content: ORIZBETH CORTES MSW (NPI 1457735581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457735581 NPI number — ORIZBETH CORTES MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CORTES
Provider First Name:
ORIZBETH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457735581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 N TUSTIN AVE STE B
Provider Second Line Business Mailing Address:
SUITE D-1
Provider Business Mailing Address City Name:
SANTA ANA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92705-3509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-247-4330
Provider Business Mailing Address Fax Number:
714-492-8265

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 N TUSTIN AVE STE B
Provider Second Line Business Practice Location Address:
SUITE D-1
Provider Business Practice Location Address City Name:
SANTA ANA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92705-3509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-247-4330
Provider Business Practice Location Address Fax Number:
714-492-8265
Provider Enumeration Date:
07/18/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  67364 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 67364 . This is a "BOARD OF BEHAVIORAL SCIENCES" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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