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CRYSTAL CELESTE ORTIZ
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1841664141
Individual Registrant: CRYSTAL CELESTE ORTIZ
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
311 E MERCED ST FOWLER, CA 93625-2316 US
Tel: 555-892-9452 Fax: --
Tel: 555-892-9452 Fax: --
Contact information for business:
316 E SPRUCE AVE LEMOORE, CA 93245-2053 US
Tel: 559-205-4035 Fax: --
Tel: 559-205-4035 Fax: --
Registration Information:
NPI: 1841664141
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 390200000X | Student Organized Health Care Education/Training Program | ||
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor | CA | 3997 |
| N | 101Y00000X | Behavioral Health & Social Service Providers Counselor | CA | 3997 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
