Provider Demographics
NPI:1790119089
Name:ORTEZA, DANILO SAVEDRA
Entity Type:Individual
Prefix:MR
First Name:DANILO
Middle Name:SAVEDRA
Last Name:ORTEZA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:DANILO
Other - Middle Name:SAVEDRA
Other - Last Name:ORTEZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:3262 FLORESTA DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-1609
Mailing Address - Country:US
Mailing Address - Phone:408-674-4379
Mailing Address - Fax:
Practice Address - Street 1:438 N WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1439
Practice Address - Country:US
Practice Address - Phone:408-254-6828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN241039164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse