Provider Demographics
NPI:1407083678
Name:ORTANEZ, CAMILLE (LCSW, LPCC)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:ORTANEZ
Suffix:
Gender:F
Credentials:LCSW, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20501 VENTURA BLVD. SUITE 213
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2337
Mailing Address - Country:US
Mailing Address - Phone:818-922-4367
Mailing Address - Fax:818-716-5054
Practice Address - Street 1:20501 VENTURA BLVD. SUITE 213
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2337
Practice Address - Country:US
Practice Address - Phone:818-922-4367
Practice Address - Fax:818-716-5054
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 246161041C0700X
CALCS246161041C0700X
CALPC391101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADH532AMedicare PIN