| Doctor Name: | RICHARD EUGENE ORTIGO |
| NPI Number: | 1154551158 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSYD |
| License Number: | PSY10692 |
| Business Practice Address: | 21660 Copley Dr Ste 350 Diamond Bar, CA - 917655508 |
| Business Phone Number: | 9096120601 |
| Business Fax Number: | 9096120602 |
| Mailing Address: | 601 N Kenwood St Unit 101, GLENDALE |
| State: | CA |
| Postal Code: | 912062372 |
| Phone Number: | 8185458561 |
| Fax Number: | 9096120602 |
| NPI Enumeration Date: | 07/24/2009 |
| NPI Last Update Date: | 07/24/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY10692 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |