Provider Demographics
NPI:1073670311
Name:ORTIZ, VERONICA (CNM)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2344 OLD SONOMA RD
Mailing Address - Street 2:BUILDING G
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2344 OLD SONOMA RD
Practice Address - Street 2:BUILDING G
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3708
Practice Address - Country:US
Practice Address - Phone:707-253-4227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA514893367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife