Provider Demographics
NPI:1356951909
Name:ORTIZ, NEMESIS
Entity type:Individual
Prefix:
First Name:NEMESIS
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32565 CANYON VISTA RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-9307
Mailing Address - Country:US
Mailing Address - Phone:760-660-5133
Mailing Address - Fax:
Practice Address - Street 1:32565 CANYON VISTA RD UNIT B
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-9307
Practice Address - Country:US
Practice Address - Phone:760-660-5133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA683349164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse