Provider Demographics
NPI:1518744572
Name:ORTIZ SOTO, JEANETE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JEANETE
Middle Name:
Last Name:ORTIZ SOTO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MRS
Other - First Name:JEANETE
Other - Middle Name:
Other - Last Name:ORTIZ SOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-0623
Mailing Address - Country:US
Mailing Address - Phone:787-341-4834
Mailing Address - Fax:
Practice Address - Street 1:BO JACANAS ABAJO
Practice Address - Street 2:CARRETERA 902
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-0623
Practice Address - Country:US
Practice Address - Phone:787-341-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR152771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical