Provider Demographics
NPI:1033481452
Name:ORTEGA, JOE SEBASTIAN
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:SEBASTIAN
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:SEBASTIAN
Other - Last Name:ORTEGA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:200 N MESA HILLS DR APT 1101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4854
Mailing Address - Country:US
Mailing Address - Phone:915-599-7972
Mailing Address - Fax:
Practice Address - Street 1:200 N MESA HILLS DR APT 1101
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4854
Practice Address - Country:US
Practice Address - Phone:915-599-7972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor