| Doctor Name: | DR. HENRY JAMES ORTIZ |
| NPI Number: | 1538303094 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PSY.D. |
| License Number: | PSY19605 |
| Business Practice Address: | 12301 Wilshire Blvd., Suite 210 West Los Angeles, CA - 90025 |
| Business Phone Number: | 3109297896 |
| Business Fax Number: | 3109297811 |
| Mailing Address: | 24 Brooks Ave Apt 7, VENICE |
| State: | CA |
| Postal Code: | 902913263 |
| Phone Number: | 3233254389 |
| Fax Number: | 3109297811 |
| NPI Enumeration Date: | 04/28/2009 |
| NPI Last Update Date: | 01/26/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0000X |
| License Number: | PSY19605 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |