Provider Demographics
NPI:1326194663
Name:ORTIZ, PATRICIA FRANCES (MFTINTERN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:FRANCES
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MFTINTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5258 PEBBLE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521-4535
Mailing Address - Country:US
Mailing Address - Phone:925-798-5112
Mailing Address - Fax:
Practice Address - Street 1:115 TOWN AND COUNTRY DR
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-3960
Practice Address - Country:US
Practice Address - Phone:925-837-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health