Provider Demographics
NPI:1003933060
Name:ORTEGA, JOANNE D (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:D
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08510-0441
Mailing Address - Country:US
Mailing Address - Phone:732-258-7000
Mailing Address - Fax:
Practice Address - Street 1:661 W 1ST ST STE E
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2939
Practice Address - Country:US
Practice Address - Phone:714-838-2853
Practice Address - Fax:714-838-4533
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00577700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist