Provider Demographics
NPI:1508092651
Name:ORTIZ FEBLES, ROSA MARGARITA (MA, MFTI)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:MARGARITA
Last Name:ORTIZ FEBLES
Suffix:
Gender:F
Credentials:MA, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7024 SEVILLE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4969
Mailing Address - Country:US
Mailing Address - Phone:323-588-9600
Mailing Address - Fax:323-588-9696
Practice Address - Street 1:7024 SEVILLE AVE STE D
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4969
Practice Address - Country:US
Practice Address - Phone:323-588-9600
Practice Address - Fax:323-588-9696
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF57316106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist