Provider Demographics
NPI:1679119135
Name:ORTIZ, ANDREA CATHERINE (RN, MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CATHERINE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:CATHERINE
Other - Last Name:CATTERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:111 BANK ST # 261
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-6518
Mailing Address - Country:US
Mailing Address - Phone:415-847-4662
Mailing Address - Fax:
Practice Address - Street 1:370 DEL NORTE AVE STE 201
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4142
Practice Address - Country:US
Practice Address - Phone:530-751-7201
Practice Address - Fax:530-751-2704
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95013192363L00000X
CA95013192363LF0000X
CA440291163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse