Provider Demographics
NPI:1770181778
Name:CORTES, ELVIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELVIA
Middle Name:
Last Name:CORTES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6323 SLOANE CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-2255
Mailing Address - Country:US
Mailing Address - Phone:858-260-0426
Mailing Address - Fax:
Practice Address - Street 1:6323 SLOANE CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-2255
Practice Address - Country:US
Practice Address - Phone:858-260-0426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No251S00000XAgenciesCommunity/Behavioral Health