Provider Demographics
NPI:1013224526
Name:CORTEZ, LORAINE I
Entity Type:Individual
Prefix:
First Name:LORAINE
Middle Name:I
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1363 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90011-1701
Mailing Address - Country:US
Mailing Address - Phone:213-509-1089
Mailing Address - Fax:
Practice Address - Street 1:2931 REDONDO AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2445
Practice Address - Country:US
Practice Address - Phone:562-490-7600
Practice Address - Fax:562-490-7681
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW286121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical