Provider Demographics
NPI:1215588207
Name:ORTEGA, REBECCA G
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:G
Last Name:ORTEGA
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 1:3174 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92501-1944
Mailing Address - Country:US
Mailing Address - Phone:951-323-6693
Mailing Address - Fax:
Practice Address - Street 1:3174 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-1944
Practice Address - Country:US
Practice Address - Phone:951-323-6693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider