Provider Demographics
NPI:1467862896
Name:ORTIZ-ALEJOS, GABRIELLA ANGELICA
Entity type:Individual
Prefix:MRS
First Name:GABRIELLA
Middle Name:ANGELICA
Last Name:ORTIZ-ALEJOS
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 1:258 NORTH THOMPSON STREET
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543
Mailing Address - Country:US
Mailing Address - Phone:951-313-1753
Mailing Address - Fax:
Practice Address - Street 1:258 N THOMPSON ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4311
Practice Address - Country:US
Practice Address - Phone:951-313-1753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-CZVOYN175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist