Provider Demographics
NPI:1225591472
Name:ORTIZ, VIRIDIANA
Entity Type:Individual
Prefix:
First Name:VIRIDIANA
Middle Name:
Last Name:ORTIZ
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 1:9314 JUANCHIDO LN
Mailing Address - Street 2:
Mailing Address - City:YSLETA DEL SUR PUEBLO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-6832
Mailing Address - Country:US
Mailing Address - Phone:915-860-6170
Mailing Address - Fax:915-242-6556
Practice Address - Street 1:9314 JUANCHIDO LN
Practice Address - Street 2:
Practice Address - City:YSLETA DEL SUR PUEBLO
Practice Address - State:TX
Practice Address - Zip Code:79907-6832
Practice Address - Country:US
Practice Address - Phone:915-860-6170
Practice Address - Fax:915-242-6556
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical