Provider Demographics
NPI:1043881121
Name:ORMONDE, MARIA (DPA, MSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ORMONDE
Suffix:
Gender:F
Credentials:DPA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11251 SIERRA AVE 2E
Mailing Address - Street 2:#715
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337
Mailing Address - Country:US
Mailing Address - Phone:909-522-1731
Mailing Address - Fax:
Practice Address - Street 1:2085 RUSTIN AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-2498
Practice Address - Country:US
Practice Address - Phone:951-509-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW92943104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker