Provider Demographics
NPI:1568839645
Name:ORTEGA, PATTY FERNANDEZ
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:FERNANDEZ
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 H ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1913
Mailing Address - Country:US
Mailing Address - Phone:661-546-6365
Mailing Address - Fax:661-868-6666
Practice Address - Street 1:820 6TH ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280
Practice Address - Country:US
Practice Address - Phone:661-758-4029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118165106H00000X
CA134277106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist