Provider Demographics
NPI:1134118391
Name:ORTEGA, DEEMS FRANCIS I (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEEMS
Middle Name:FRANCIS
Last Name:ORTEGA
Suffix:I
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 COURT AVE
Mailing Address - Street 2:SUITE 229
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2245
Mailing Address - Country:US
Mailing Address - Phone:515-699-8548
Mailing Address - Fax:515-699-8549
Practice Address - Street 1:309 COURT AVE
Practice Address - Street 2:SUITE 229
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2245
Practice Address - Country:US
Practice Address - Phone:515-699-8548
Practice Address - Fax:515-699-8549
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00545103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA421508035T60DC0Medicaid
IA421508035T60DC0Medicaid
IAI1017Medicare ID - Type Unspecified