Provider Demographics
NPI:1477924090
Name:ORTEGA, DAMASO SOTO SR (MCSW 13080)
Entity Type:Individual
Prefix:MR
First Name:DAMASO SOTO
Middle Name:
Last Name:ORTEGA
Suffix:SR
Gender:M
Credentials:MCSW 13080
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A11 HACIENDA OLIVIERY
Mailing Address - Street 2:URB SANTA MARIA
Mailing Address - City:GUAYANILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00656
Mailing Address - Country:US
Mailing Address - Phone:787-375-7077
Mailing Address - Fax:
Practice Address - Street 1:A 11 HACIENDA OLIVIERY
Practice Address - Street 2:URB SANTA MARIA
Practice Address - City:GUAYANILLA
Practice Address - State:PR
Practice Address - Zip Code:00656
Practice Address - Country:US
Practice Address - Phone:787-375-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical