Doctor Name: | KAYLE ORTEGA |
NPI Number: | 1205202975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 16734 13th St Huron, CA - 93234 |
Business Phone Number: | 5595728023 |
Business Fax Number: | |
Mailing Address: | Po Box 72, HURON |
State: | CA |
Postal Code: | 93234 |
Phone Number: | 5595728023 |
Fax Number: | |
NPI Enumeration Date: | 08/18/2015 |
NPI Last Update Date: | 08/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |