Provider Demographics
NPI:1942087416
Name:ESTRADA-ORTIZ, ANGELA (CSWI)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:ESTRADA-ORTIZ
Suffix:
Gender:F
Credentials:CSWI
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:ORTIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:3790 GRANT DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5318
Mailing Address - Country:US
Mailing Address - Phone:602-619-9011
Mailing Address - Fax:
Practice Address - Street 1:6490 S MCCARRAN BLVD BLDG A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6165
Practice Address - Country:US
Practice Address - Phone:775-448-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVIC-22781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical