Provider Demographics
NPI:1598113904
Name:ORTA, ALICIA S (MPH, MS)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:S
Last Name:ORTA
Suffix:
Gender:F
Credentials:MPH, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 4360
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1618
Mailing Address - Country:US
Mailing Address - Phone:415-600-6400
Mailing Address - Fax:415-600-2245
Practice Address - Street 1:3700 CALIFORNIA ST
Practice Address - Street 2:SUITE 4360
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1618
Practice Address - Country:US
Practice Address - Phone:415-600-6400
Practice Address - Fax:415-600-2245
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS